Individual
JESSICA LANIER MILLER
Active
Individual
JESSICA LANIER MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008670
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10062648
AMERIGROUP-AAKTS
GA
05
—
147217028A
—
GA
01
—
340247
WELLCARE-AAKTS
GA
Enumeration date
12/05/2006
Last updated
03/15/2011
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