Individual
TRACEY S MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18211 KELLY BLVD APT 1632, DALLAS, TX 75287-4646
(214) 664-5659
Mailing address
18211 KELLY BLVD APT 1632, DALLAS, TX 75287-4646
(214) 664-5659
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
39417597
TX
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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