Individual
CARL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 OAK LN, STILLWATER, NY 12170-2210
(518) 796-2096
Mailing address
4 OAK LN, STILLWATER, NY 12170-2210
(518) 796-2096
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
287378
NY
Other
Enumeration date
12/07/2013
Last updated
12/07/2013
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