Provider Demographics
NPI:1417515149
Name:MILLER, DANYELLE C (DPT)
Entity type:Individual
Prefix:
First Name:DANYELLE
Middle Name:C
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 1:2453 US HIGHWAY 17 STE G
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5960
Mailing Address - Country:US
Mailing Address - Phone:912-445-5612
Mailing Address - Fax:912-445-5653
Practice Address - Street 1:2453 US HIGHWAY 17 STE G
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-5960
Practice Address - Country:US
Practice Address - Phone:912-445-5612
Practice Address - Fax:912-445-5653
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007272225100000X
GAPT014560225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist