Individual
JEREMY EDWARD MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5338 W SPAULDING ST, BOISE, ID 83705-2741
(208) 972-7547
Mailing address
5338 W SPAULDING ST, BOISE, ID 83705-2741
(208) 972-7547
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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