Provider Demographics
NPI:1316783822
Name:MILLER, MADELINE (DPT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 DEER VALLEY XING
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7985
Mailing Address - Country:US
Mailing Address - Phone:614-796-3797
Mailing Address - Fax:
Practice Address - Street 1:5280 US HIGHWAY 62 AND 68
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:OH
Practice Address - Zip Code:45167-8650
Practice Address - Country:US
Practice Address - Phone:614-796-3797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
OH020474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist