Individual
JASON TODD MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED., ATC
Contact information
Practice address
65 DUTCH LN, COLUMBUS, MS 39702-5523
(662) 425-4545
Mailing address
65 DUTCH LN, COLUMBUS, MS 39702-5523
(662) 425-4545
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT549
MS
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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