# WILVAN M MILLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1891760245
- **Gender:** Man
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 00607 | LA | Yes |

## Other

- **Enumeration date:** 02/21/2006
- **Last updated:** 08/31/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 6400015 | UNITED HEALTHCARE | LA |
| 01 | — | C3525 | BC/BS-LA INDIV PROV \# | LA |