Individual
MR. KENNETH EDMUND MILLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 N FAIRLAND ST, SUITE 101, PRYOR, OK 74361-4203
(918) 825-2884
(918) 825-2234
Mailing address
109 N FAIRLAND ST STE 101, PRYOR, OK 74361-4225
(918) 825-2884
(918) 825-2234
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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