Organization
MILLER SPORTS & WELLNESS CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESE MILLER D.C. (OWNER)
(262) 366-3655
Entity
Organization
Contact information
Practice address
2363 S 102ND ST, SUITE 304, WEST ALLIS, WI 53227-2143
(262) 366-3655
(262) 565-4304
Mailing address
2363 S 102ND ST, SUITE 304, WEST ALLIS, WI 53227-2143
(262) 366-3655
(262) 565-4304
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4664-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497055644
TYPE I NPI
WI
05
—
71405
—
WI
Enumeration date
05/19/2011
Last updated
05/19/2011
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