Individual
MICHAEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
201 W VAN ASCHE LOOP, FAYETTEVILLE, AR 72703-4996
(479) 996-4491
(479) 966-4311
Mailing address
PO BOX 251420, LITTLE ROCK, AR 72225-1420
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
16063
AR
111NI0900X
Internist Chiropractor
2014003605
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
RAILROAD MEDICARE
MO
Enumeration date
03/13/2014
Last updated
03/23/2021
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