1750711594 NPI number — MRS. DEBORAH ANN MILLER LPTA

Table of content: MRS. DEBORAH ANN MILLER LPTA (NPI 1750711594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750711594 NPI number — MRS. DEBORAH ANN MILLER LPTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPTA
Provider Gender Code:
F

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:
1750711594
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
528 ROTHROCK RD SUITE 343
Provider Second Line Business Mailing Address:
THE COPLEY PLACE
Provider Business Mailing Address City Name:
COPLEY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44321
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-576-3496
Provider Business Mailing Address Fax Number:
330-576-3496

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
528 ROTHROCK RD SUITE 343
Provider Second Line Business Practice Location Address:
THE COPLEY PLACE
Provider Business Practice Location Address City Name:
COPLEY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-416-4833
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225200000X , with the licence number:  03929 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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