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Individual

LECORY MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2259 SHARON RD, CANTON, MS 39046-8727
(281) 923-5895
Mailing address
2259 SHARON RD, CANTON, MS 39046-8727
(281) 923-5895

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-010297
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
40519
TEXAS BOARD OF PHARMACY
TX
01
E-010297
MISSISSIPPI BOARD OF PHARMACY
MS
Enumeration date
10/19/2022
Last updated
10/19/2022
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