Provider Demographics
NPI:1174096135
Name:MILLER PHYSICAL THERAPY AT HOME
Entity type:Organization
Organization Name:MILLER PHYSICAL THERAPY AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:561-278-6055
Mailing Address - Street 1:247 SE 6TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5208
Mailing Address - Country:US
Mailing Address - Phone:561-278-6055
Mailing Address - Fax:561-278-6670
Practice Address - Street 1:247 SE 6TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5208
Practice Address - Country:US
Practice Address - Phone:561-278-6055
Practice Address - Fax:561-278-6670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty