Provider Demographics
NPI:1679018188
Name:MILLER, BLAIR ASHLEY (DC)
Entity type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:ASHLEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 DOUBLE CREEK DR STE 304
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3831
Mailing Address - Country:US
Mailing Address - Phone:512-246-0220
Mailing Address - Fax:
Practice Address - Street 1:2251 DOUBLE CREEK DR STE 304
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3831
Practice Address - Country:US
Practice Address - Phone:512-246-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor