Provider Demographics
NPI:1316945215
Name:MILLER, STEVEN E (PT,CPED)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT,CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 E POMFRET ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2579
Mailing Address - Country:US
Mailing Address - Phone:717-245-0400
Mailing Address - Fax:717-243-5688
Practice Address - Street 1:290 E POMFRET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2579
Practice Address - Country:US
Practice Address - Phone:717-245-0400
Practice Address - Fax:717-243-5688
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015053225100000X
PACPED2750224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA052740MV7Medicare PIN
PA052740U1SMedicare PIN
PA5874630001Medicare NSC