Individual
IDA MAE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18731 COUNTRY CLUB CIR, RIVERVIEW, MI 48193-8151
(734) 752-9530
Mailing address
18731 COUNTRY CLUB CIR, RIVERVIEW, MI 48193-8151
(734) 752-9530
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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