Provider Demographics
NPI:1861779100
Name:MILLER, JOSHUA GARVIN (PT, DPT, COMT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:GARVIN
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT, DPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-1631
Mailing Address - Country:US
Mailing Address - Phone:304-728-1610
Mailing Address - Fax:304-725-3690
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3402
Practice Address - Country:US
Practice Address - Phone:304-728-1610
Practice Address - Fax:304-725-3690
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT002188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist