Basic Information
| Provider Information | |||||||||
| NPI: | 1417193186 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | JEANETTE | ||||||||
| MiddleName: | BRIANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12120 ROUTE 30 | ||||||||
| Address2: | |||||||||
| City: | NORTH HUNTINGDON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156421840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248644155 | ||||||||
| FaxNumber: | 7248644659 | ||||||||
| Practice Location | |||||||||
| Address1: | 12120 ROUTE 30 | ||||||||
| Address2: | |||||||||
| City: | NORTH HUNTINGDON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156421840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248644155 | ||||||||
| FaxNumber: | 7248644659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2008 | ||||||||
| LastUpdateDate: | 11/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT019674 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.