Individual
MR. KEITH ALLEN MILLER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT-P
Contact information
Practice address
419 HERMAN ST, CRETE, IL 60417-2905
(708) 927-6701
Mailing address
422 HERMAN ST, CRETE, IL 60417-2906
(708) 927-6701
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003840
IL
Other
Enumeration date
11/04/2014
Last updated
03/13/2019
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