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Individual

DR. MARK MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
450 S CAMINO DEL RIO, SUITE 101, DURANGO, CO 81301-6856
(970) 247-3613
(970) 247-5823
Mailing address
450 S CAMINO DEL RIO, SUITE 101, DURANGO, CO 81301-6856
(970) 247-3613
(970) 247-5823

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1837
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08918377
CO
Enumeration date
09/27/2007
Last updated
09/27/2007
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