Marc Miller

Individual provider Active NPI Physical Therapist · Velva, ND

NPI 1154777944 · NPPES record last updated Sep 15, 2021

Key facts

NPI
1154777944
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2024 (ND)
Practice address
300 Main St S
Velva, ND 58790-7342
Phone
(701) 338-2072
NPI assigned
May 11, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2024NDMDClinical Social Worker
291043CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 291043 CA
Physical Therapist 225100000X 2024 ND Yes

Addresses

Primary practice location

300 Main St S
Velva, ND 58790-7342

Mailing address

300 Main St S
Velva, ND 58790-7342

Other providers in Velva, ND

All providers in Velva, ND · Physical Therapist in North Dakota

Sources for this page

Verify at the official NPI Registry.