Individual
MAXWELL S MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1021 CENTRAL AVE, DEMOREST, GA 30535-5252
(502) 498-9730
Mailing address
123 FERNWOOD DR # 2, WOODSTOCK, GA 30188-6241
(502) 498-9730
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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