Individual
GENNI LEE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC, PTA
Contact information
Practice address
1210 CORINTH RD, JACKSONVILLE, TX 75766-3208
(903) 586-1704
Mailing address
260 COUNTY ROAD 1518, JACKSONVILLE, TX 75766-6593
(903) 724-3232
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT1256
TX
225200000X
Physical Therapy Assistant
2076630
TX
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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