Provider Demographics
NPI:1427118306
Name:MILLER, WILLIAM NEAL (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:NEAL
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-1332
Mailing Address - Country:US
Mailing Address - Phone:610-490-3910
Mailing Address - Fax:610-490-3904
Practice Address - Street 1:1 EAST BEACON LIGHT LANE
Practice Address - Street 2:SUITE B
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4433
Practice Address - Country:US
Practice Address - Phone:610-490-3900
Practice Address - Fax:610-490-3912
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0002796L208100000X
PT0002796L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001777981OtherHIGHMARK BLUESHIELD
PW0761058000OtherINDEPENDENCE BLUE CROSS
0761058000OtherIBC
0761058000OtherIBC