Individual
JACQUELINE RENE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2610 ASSOCIATED RD, APT A4, FULLERTON, CA 92835
(209) 543-2272
Mailing address
5210 E HAMPTON AVE APT 1137, MESA, AZ 85206-3453
(209) 543-2272
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/27/2017
Last updated
06/20/2018
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