Individual
MR. MILES EDWARD EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D., R.N.
Contact information
Practice address
80 PHOENIX AVE, WATERBURY, CT 06702-1418
(203) 756-8021
Mailing address
561 HICKORY HILL RD, THOMASTON, CT 06787-1022
(347) 406-4714
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
000825
CT
163WD0400X
Diabetes Educator Registered Nurse
082032
CT
Other
Enumeration date
09/27/2007
Last updated
11/13/2007
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