Individual
MATTHEW USMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12509 OAK FOREST DR, GULFPORT, MS 39503-5730
(228) 860-5636
Mailing address
12509 OAK FOREST DR, GULFPORT, MS 39503-5730
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86070183
MS
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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