Individual
MR. VICTOR JEROME MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1800 SOUTH 4TH STREET, AMES, IA 50011
(515) 294-4307
(515) 294-6554
Mailing address
2801 SW 28TH STREET, ANKENY, IA 50023
(515) 289-3791
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00293
IA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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