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Individual

MARY SARAH MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 347-2511
Mailing address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 347-2511

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
281
AK
152W00000X
Optometrist
3013
CO
152W00000X
Optometrist
Primary
768
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71600370
CO
Enumeration date
08/07/2008
Last updated
03/19/2024
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