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Individual
BODEN L MILLER
Active
Individual
BODEN L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT006402
OH
2255A2300X
Athletic Trainer
—
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Enumeration date
08/03/2018
Last updated
06/24/2021
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