Individual
MR. SANFORD EUGENE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/LAT
Contact information
Practice address
HOMER BRYCE STADIUM/ATHLETIC FIELD HOUSE, NACOGDOCHES, TX 75962-0001
(936) 468-4550
(936) 468-4052
Mailing address
4606 RIDGEBROOK DR, NACOGDOCHES, TX 75965-2152
(936) 560-1447
(936) 468-4052
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
625
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
780641
ATHLETIC TRAINER
TX
Enumeration date
10/10/2006
Last updated
07/08/2007
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