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Individual

CHARLES LEE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
49 GRANTS RD, LIBERTY, NY 12754-2640
(845) 798-9316
Mailing address
49 GRANTS RD, LIBERTY, NY 12754-2640

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
691487
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/06/2018
Last updated
07/28/2025
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