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Individual

TRAVIS DANIEL MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1078 HOSPITAL RD, FORT STORY, VA 23459-1197
(757) 422-7936
(757) 422-7949
Mailing address
1078 HOSPITAL RD, FORT STORY, VA 23459-1197
(757) 422-7936
(757) 422-7949

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
01/28/2008
Last updated
01/28/2008
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