Provider Demographics
NPI:1801912993
Name:MILLER, JENNIFER EILEEN (PTA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:EILEEN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PTA
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Mailing Address - Street 1:1846 OAKLAND DR
Mailing Address - Street 2:APT # 2
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1869
Mailing Address - Country:US
Mailing Address - Phone:269-547-8670
Mailing Address - Fax:
Practice Address - Street 1:1423 W CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5351
Practice Address - Country:US
Practice Address - Phone:269-323-4300
Practice Address - Fax:269-323-4449
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant