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Individual

MRS. MICHELLE L. MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
902 E OAK ST, SUITE 3, FAIRBURY, IL 61739-1390
(815) 692-6200
(815) 692-6202
Mailing address
902 E OAK ST, SUITE 3, FAIRBURY, IL 61739-1390
(815) 692-6200
(815) 692-6202

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
96.000758
IL

Other

Enumeration date
03/03/2010
Last updated
03/03/2010
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