Individual
MICK MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC/8403
Contact information
Practice address
2D RECONNAISSANCE BATTALION, PSC BIX 20138, CAMP LEJEUNE, NC 28542
(406) 647-5806
Mailing address
1880 ROSWELL ST SE, SMYRNA, GA 30080-2216
(406) 647-5806
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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