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Individual

JASONN MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
2001 VAIL AVE STE 200A, CHARLOTTE, NC 28207
(704) 323-3160
Mailing address
10300 WILLOW RUN RD APT 1F, CHARLOTTE, NC 28210-0117

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1559
NC

Other

Enumeration date
02/24/2010
Last updated
10/20/2019
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