Individual
JESSE D MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, MS, ECS
Contact information
Practice address
129 S MAIN ST, SUITE B, HIAWASSEE, GA 30546-3435
(706) 896-7060
Mailing address
PO BOX 2696, BLUE RIDGE, GA 30513-0048
(706) 258-7253
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6124
TN
225100000X
Physical Therapist
6473
GA
225100000X
Physical Therapist
Primary
8554
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000848537A
—
GA
05
—
3652413
—
TN
Enumeration date
06/10/2005
Last updated
08/09/2016
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