Individual
MR. CHARLES DAVID MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAED, ATC
Contact information
Practice address
900 N CLARKSON ST, FREMONT, NE 68025-4254
(402) 941-6359
(402) 941-6011
Mailing address
2227 PARKVIEW DR, FREMONT, NE 68025-4519
(402) 366-9338
(402) 941-6011
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
349
NE
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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