Individual
SAMUEL ROBERT MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
193 N PAW PAW ST, COLOMA, MI 49038-9792
(850) 313-1869
Mailing address
913 FOREST PARK AVE, WATERVLIET, MI 49098-9316
(850) 313-1869
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
032972
NY
225700000X
Massage Therapist
Primary
7501017099
MI
Other
Enumeration date
05/12/2022
Last updated
05/16/2026
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