Individual
MICHAEL JOHNATHAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3131 ADAMS ST NE APT E28, ALBUQUERQUE, NM 87110-8027
(772) 971-8230
Mailing address
3131 ADAMS ST NE APT E28, ALBUQUERQUE, NM 87110-8027
(772) 971-8230
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0TA.0000858
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3808
COTA
NM
Enumeration date
07/03/2019
Last updated
07/03/2019
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