Individual
CA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4275 CAPITAL AVE SW, BATTLE CREEK, MI 49015-9358
(269) 979-1561
(269) 979-1561
Mailing address
4275 CAPITAL AVE SW, BATTLE CREEK, MI 49015-9358
(269) 979-1561
(269) 979-1561
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002557
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A36524
PTAN
MI
05
—
5048562
—
MI
Enumeration date
01/08/2007
Last updated
06/03/2013
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