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Individual

MICHAEL MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
893 MAIN STREET SUITE 302, EAST HARTFORD, CT 06108-3228
(860) 289-6021
Mailing address
563 GOFF RD, WETHERSFIELD, CT 06109-2106
(203) 641-8431

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007405
LICENSE
CT
Enumeration date
08/29/2006
Last updated
11/13/2008
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