Individual
MR. KENNETH B MILLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
9110 PHILADELPHIA RD, SUITE 208, BALTIMORE, MD 21237-4301
(443) 460-4000
Mailing address
125 AMESBURY CT, SEVERNA PARK, MD 21146-1222
(410) 544-7983
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15052
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323-541
MAMSI
MD
01
—
S484-0003
CAREFIRST
MD
Enumeration date
03/23/2007
Last updated
07/08/2007
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