Individual
SARAH REBECCA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16493 BLUEWOOD PL # 5, LA PINE, OR 97739-7526
(541) 536-5711
Mailing address
52437 LOST PONDEROSA RD, LA PINE, OR 97739-9519
(541) 420-6653
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
20107
OR
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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