Individual
JEREMY D MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5151 PARK AVE, FAIRFIELD, CT 06825-1090
(413) 896-4353
Mailing address
343 NEWBURY ST, SPRINGFIELD, MA 01104-2524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
S47445874
MA
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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