Individual
CRYSTAL ROSE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1923 E ECKERMAN AVE, WEST COVINA, CA 91791-1113
(626) 332-4600
Mailing address
158 GENTRY ST, POMONA, CA 91767-2100
(909) 599-8222
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
10/11/2021
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