Individual
JEAN A MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, PT
Contact information
Practice address
17 E GENESEE ST, SUITE #101, AUBURN, NY 13021-4040
(315) 253-5151
(315) 253-0841
Mailing address
17 LANSING ST, AMMS, PC CREDENTIALING OFFICE, AUBURN, NY 13021-1983
(315) 255-7438
(315) 255-7099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13066
NY
363AS0400X
Surgical Physician Assistant
Primary
013624
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02399411
—
NY
Enumeration date
03/22/2007
Last updated
07/16/2013
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