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Individual

CLARENCE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
600 S RANCHO DR STE 103, LAS VEGAS, NV 89106-4806
(702) 258-9381
(702) 258-9584
Mailing address
848 N RAINBOW BLVD # 357, LAS VEGAS, NV 89107-1103
(702) 256-9738
(702) 242-5629

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004117
KY
225100000X
Physical Therapist
Primary
2335
NV
225100000X
Physical Therapist
5247
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1396707626
NV
Enumeration date
04/03/2006
Last updated
07/20/2009
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