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Individual
MIRACLE A DOUGLAS
Active
Individual
MIRACLE A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
CP023035T
TN
225100000X
Physical Therapist
Primary
PT014961
GA
225100000X
Physical Therapist
PT31362
FL
2251P0200X
Pediatric Physical Therapist
PT014961
GA
Other
Enumeration date
05/16/2016
Last updated
02/17/2026
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