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Organization

ANNIE MILLER PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNIE MILLER OD (OWNER/MANAGER)
(269) 467-0056
Entity
Organization

Contact information

Practice address
124 E PRAIRIE ST, VICKSBURG, MI 49097-1257
(269) 649-0103
(269) 649-4762
Mailing address
124 E PRAIRIE ST, VICKSBURG, MI 49097-1257
(269) 649-0103
(269) 649-4762

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4901004917
STATE LICENSE
MI
Enumeration date
09/23/2021
Last updated
03/07/2022
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