Individual
MR. KENT SYLVESTER MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27332 OUTRIGGER LANE, HELENDALE, CA 92342
(760) 590-8112
Mailing address
PO BOX 1411, HELENDALE, CA 92342
(760) 590-8112
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C6750664
CA
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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