Basic Information
| Provider Information | |||||||||
| NPI: | 1003115163 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | ADAM | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 G ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200014545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2023477745 | ||||||||
| FaxNumber: | 2023477747 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 G ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200014545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2023477745 | ||||||||
| FaxNumber: | 2023477747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2011 | ||||||||
| LastUpdateDate: | 03/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT871217 | DC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.