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Individual

KENDRA MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
800 N 1ST ST, SPRINGFIELD, IL 62702-3778
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2499
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006896
IL

Other

Enumeration date
05/03/2019
Last updated
05/03/2019
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