1669542411 NPI number — VERN K MILLER DC PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669542411 NPI number — VERN K MILLER DC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VERN K MILLER DC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669542411
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2601 SOUTH LEMAY AVE
Provider Second Line Business Mailing Address:
SUITE 25
Provider Business Mailing Address City Name:
FT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-223-9993
Provider Business Mailing Address Fax Number:
970-223-9994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 SOUTH LEMAY AVE
Provider Second Line Business Practice Location Address:
SUITE 25
Provider Business Practice Location Address City Name:
FT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-223-9993
Provider Business Practice Location Address Fax Number:
970-223-9994
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
VERN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
970-223-9993

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1907 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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