Individual
MACKENZIE ANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 COLLEGE HL, CANTON, MO 63435-1257
(573) 333-7561
Mailing address
21034 GINKGO ST, LEWISTOWN, MO 63452-2406
(605) 999-3612
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2024021221
MO
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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