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Individual

DR. RYAN L MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
107 MAPLE ST, MOSINEE, WI 54455
(715) 693-4144
Mailing address
107 MAPLE ST, MOSINEE, WI 54455-1924
(715) 693-4144
(715) 692-2663

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4183-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38965200
WI
01
38987000
MEDICAID GROUP
WI
Enumeration date
09/20/2006
Last updated
11/22/2019
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