Individual
KIRK MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
16985 N 2400TH ST, MONTROSE, IL 62445-5004
(217) 259-3849
Mailing address
16985 N 2400TH ST, MONTROSE, IL 62445-5004
(217) 259-3849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006955
IL
Other
Enumeration date
01/27/2017
Last updated
03/06/2019
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