Individual
JUANITA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 CHESTNUT HILL RD, FORT VALLEY, GA 31030-7391
(937) 416-4561
Mailing address
1205 CHESTNUT HILL RD, FORT VALLEY, GA 31030-7391
(937) 416-4561
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
198063
GA
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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