Individual
BETHANY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
331 S MAIN ST, RICE LAKE, WI 54868-2253
(715) 236-8719
Mailing address
331 S MAIN ST, RICE LAKE, WI 54868-2253
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1273-39
WI
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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