Individual
EVAN ROSS MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2115 WINDSOR SPRING RD STE 23, AUGUSTA, GA 30906-4883
(706) 868-1707
Mailing address
415 TOWN PARK BLVD, EVANS, GA 30809-3487
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013964
GA
Other
Enumeration date
06/06/2019
Last updated
08/08/2019
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