Individual
DR. GREGORY RUSSELL MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
814 BAMBERGER DR, AMERICAN FORK, UT 84003-2165
(801) 772-0202
Mailing address
814 BAMBERGER DR, AMERICAN FORK, UT 84003-2165
(801) 772-0202
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8523640-2501
UT
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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