Individual
DOMENICK MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
551 W LANCASTER AVE, HAVERFORD, PA 19041-1419
(215) 853-7421
Mailing address
5 QUASAR CT, SEWELL, NJ 08080-2224
(215) 853-7421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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