Individual
JASMINE SYIN-LAN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1301 E COLVIN ST, SYRACUSE, NY 13244-4403
(315) 559-5317
Mailing address
8089 WILD LEMON LN, MANLIUS, NY 13104-9792
(315) 559-5317
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003514A
IN
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000042441
BOC CERTIFIATION
—
01
—
300263
NATA MEMBER NUMBER
—
01
—
36003514A
INDIANA AT LICENSE
IN
Enumeration date
11/25/2019
Last updated
07/07/2023
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