Individual
DR. KATHRYN MAE MILLER STAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1804 TROTT AVE SW, WILLMAR, MN 56201-1614
(320) 235-0880
Mailing address
1804 TROTT AVE SW, PO BOX 1614, WILLMAR, MN 56201-1614
(320) 235-0880
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2439
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19351MI
BCBS
—
05
—
73002800
—
MN
Enumeration date
11/28/2006
Last updated
12/12/2011
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