Individual
CLYDE MILLER JR. III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
260 NESTER ST, ROCHESTER, NY 14621-2435
(585) 230-7824
Mailing address
260 NESTER ST, ROCHESTER, NY 14621-2435
(585) 230-7824
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300694-1
NY
Other
Enumeration date
11/08/2010
Last updated
06/05/2019
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