Provider Demographics
NPI:1699520106
Name:MILLER, BRYAN SCOTT (CPSS)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:SCOTT
Last Name:MILLER
Suffix:
Gender:M
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HWY KY-227
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-4642
Mailing Address - Country:US
Mailing Address - Phone:606-231-1567
Mailing Address - Fax:
Practice Address - Street 1:3444 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-9056
Practice Address - Country:US
Practice Address - Phone:606-231-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist