Individual
JACOB WAYNE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6516 MEADOWLARK LN EAST, WATAUGA, TX 76148-7614
(817) 683-8796
Mailing address
6516 MEADOWLARK LN E, WATAUGA, TX 76148-1734
(817) 683-8796
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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