| Doctor Name: | MR. MARK CAMPBELL MILES |
| NPI Number: | 1073590980 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 5501005513 |
| Business Practice Address: | 1007 Harbor Hills Dr Suite A Marquette, MI - 498558859 |
| Business Phone Number: | 9062255585 |
| Business Fax Number: | 9062255990 |
| Mailing Address: | 120 Briarwood Dr, MARQUETTE |
| State: | MI |
| Postal Code: | 498559390 |
| Phone Number: | 9062491858 |
| Fax Number: | 9062255990 |
| NPI Enumeration Date: | 12/30/2005 |
| NPI Last Update Date: | 12/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 5501005513 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |