Individual
CASSANDRA A. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, OCS
Contact information
Practice address
5859 HARBOUR VIEW BLVD STE 100, SUFFOLK, VA 23435-3015
(757) 686-0205
Mailing address
106 W ARDEN CIR, NORFOLK, VA 23505-4828
(518) 461-5515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208363
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245648880
MEDICAID QMB
VA
01
—
C05954
MEDICARE GROUP PTAN
VA
Enumeration date
07/28/2014
Last updated
07/09/2019
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