Individual
KERRY RYAN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 FM 126, MERKEL, TX 79536-7953
(325) 370-5909
Mailing address
109 FM 126, MERKEL, TX 79536
(325) 370-5909
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2122370
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001028687
—
TX
01
—
676416
MCR
TX
Enumeration date
08/24/2018
Last updated
08/24/2018
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