Provider Demographics
NPI:1528105871
Name:MILLER, CHRISTINE DIANE (DC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:DIANE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4585 STATE RT 39 SUITE C
Mailing Address - Street 2:PO BOX 301
Mailing Address - City:BERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44610
Mailing Address - Country:US
Mailing Address - Phone:330-893-3438
Mailing Address - Fax:330-893-2315
Practice Address - Street 1:4585 STATE RT 39
Practice Address - Street 2:SUITE C
Practice Address - City:BERLIN
Practice Address - State:OH
Practice Address - Zip Code:44610
Practice Address - Country:US
Practice Address - Phone:330-893-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMI0784631Medicare ID - Type Unspecified