Individual
MR. JACK GLENN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTN
Contact information
Practice address
1308 N STOCKTON HILL RD STE A-153, KINGMAN, AZ 86401-5139
(928) 565-5853
Mailing address
1308 N STOCKTON HILL RD STE A, KINGMAN, AZ 86401-5190
(928) 565-5853
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
—
—
175L00000X
Homeopath
Primary
—
—
Other
Enumeration date
02/24/2011
Last updated
01/25/2013
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