Individual
IAN DOUGLAS MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
198 FOUR STATES DR., SUITE 1, GALENA, KS 66739-4305
(620) 783-2356
(620) 783-2395
Mailing address
198 FOUR STATES DR STE 1, GALENA, KS 66739-4305
(620) 783-2356
(620) 783-2395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2009026344
MO
Other
Enumeration date
09/11/2009
Last updated
07/06/2016
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