Individual
LARRY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
88
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42915600
—
WI
Enumeration date
09/20/2006
Last updated
09/29/2009
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