Individual
DESTINY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
440 MERCHANT DR, NORMAN, OK 73069-6470
(812) 628-3060
Mailing address
1110 E JENNINGS ST, WYNNEWOOD, OK 73098-2031
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3501
OK
Other
Enumeration date
03/24/2023
Last updated
03/24/2023
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