Individual
JOHNATHAN DOUGLAS MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
TETLIN CLINIC, TETLIN, AK 99779
(907) 324-2136
Mailing address
PO BOX 852, TOK, AK 99780-0852
(907) 324-2136
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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