Individual
MATTHEW S MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
2855 CAMPUS DR, PLYMOUTH, MN 55441-2649
(608) 383-3050
Mailing address
10988 LEXINGTON DR, EDEN PRAIRIE, MN 55344-4911
(608) 383-3050
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000041902
WI
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
10/27/2020
Last updated
03/28/2022
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