Provider Demographics
NPI:1871576660
Name:MILLER, TODD LEWIS (PT)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:LEWIS
Last Name:MILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 ABBOTT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4391
Mailing Address - Country:US
Mailing Address - Phone:831-649-1000
Mailing Address - Fax:831-649-4962
Practice Address - Street 1:611 ABBOTT ST STE 100
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4391
Practice Address - Country:US
Practice Address - Phone:831-755-3578
Practice Address - Fax:831-757-4612
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24618225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAY856ZMedicare PIN