Individual
JESSE GLENN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
300 W SHAWNEE ST STE B, MUSKOGEE, OK 74401-4151
(918) 683-9777
(918) 683-9778
Mailing address
300 W SHAWNEE ST STE B, MUSKOGEE, OK 74401-4151
(918) 683-9777
(918) 683-9778
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3042
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100830610A
—
OK
Enumeration date
09/29/2006
Last updated
10/02/2014
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