Individual
KENNETH A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
110 JEFFERSON ST, WEST UNION, IA 52175-1022
(563) 422-3817
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1685
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3150284
—
IA
Enumeration date
05/27/2005
Last updated
11/20/2015
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