Individual
AMY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2046 JONATHAN CREEK RD, ARTHUR, IL 61911-6108
(217) 962-0614
Mailing address
2046 JONATHAN CREEK RD, ARTHUR, IL 61911-6108
(217) 962-0614
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
LMT 8092
MT
405300000X
Prevention Professional
Primary
778931277
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164169
—
MT
Enumeration date
09/23/2015
Last updated
03/30/2019
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