Individual
JERAD MARTEL MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
500 AZ-89, PRESCOTT, AZ 86301
(928) 445-4860
Mailing address
5700 MARKET ST APT 1055, PRESCOTT VALLEY, AZ 86314-6513
(540) 498-3007
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86144393
AZ
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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