Individual
MR. GREGORY BRUCE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
256 NOKOMIS AVE S, STE. 2, VENICE, FL 34285-2357
(941) 484-1939
(941) 484-7804
Mailing address
256 NOKOMIS AVE S, STE. 2, VENICE, FL 34285-2357
(941) 484-1939
(941) 484-7804
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT2466
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4496768
AETNA
FL
01
—
Q08
BCBS OF FLORIDA
FL
Enumeration date
05/14/2007
Last updated
02/04/2011
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