Individual
MARY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4710 EASTMAN AVE, MIDLAND, MI 48640
(989) 341-1072
Mailing address
7876 BONNY DR, SAGINAW, MI 48609-4911
(989) 295-2553
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096002916
IL
2255A2300X
Athletic Trainer
Primary
2601001635
MI
Other
Enumeration date
11/24/2014
Last updated
11/26/2018
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