Individual
JOHN SAMUEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1215 SE 7TH AVE, GRAND RAPIDS, MN 55744-4201
(218) 256-0841
Mailing address
1215 SE 7TH AVE, GRAND RAPIDS, MN 55744-4201
(218) 256-0841
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305001
MN
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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