Individual
TIA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6903 ORDWAY DR, FORT WAYNE, IN 46815-7753
(260) 493-7873
Mailing address
6903 ORDWAY DR, FORT WAYNE, IN 46815-7753
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
4840149200
IN
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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