Individual
GLENN K MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
231 S WASHINGTON AVE, NEWPORT, WA 99156-9670
(509) 993-2608
Mailing address
PO BOX 176, CUSICK, WA 99119-0176
(509) 993-2608
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60862042
WA
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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