Provider Demographics
NPI:1902279854
Name:MADEIRA MILLER, KAYLA (DC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MADEIRA MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 W CARACAS AVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1510
Mailing Address - Country:US
Mailing Address - Phone:717-533-6100
Mailing Address - Fax:
Practice Address - Street 1:158 W CARACAS AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1510
Practice Address - Country:US
Practice Address - Phone:717-533-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-01
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor