Doctor Name: | MR. JAMES WIRICK MILLER |
NPI Number: | 1396733804 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC, CSCS |
License Number: | 36000455A |
Business Practice Address: | 300 N 1st St Boonville, IN - 476011516 |
Business Phone Number: | 8128974701 |
Business Fax Number: | 8128976061 |
Mailing Address: | 108 1/2 W Locust St, BOONVILLE |
State: | IN |
Postal Code: | 476011520 |
Phone Number: | 8128972203 |
Fax Number: | 8128976061 |
NPI Enumeration Date: | 10/10/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 36000455A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |