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Individual

JASON DEAN MILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
236 CALDWELL DR, HAZLEHURST, MS 39083-2723
(601) 894-9004
(601) 894-3004
Mailing address
236 CALDWELL DR, HAZLEHURST, MS 39083-2723
(601) 894-9004
(601) 894-3004

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2801
MS
225XP0019X
Physical Rehabilitation Occupational Therapist
OT2801
MS

Other

Enumeration date
12/16/2014
Last updated
12/16/2014
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