Individual
DUSTIN HENRY MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7725 N 43RD AVE, PHOENIX, AZ 85051-5770
(623) 207-5465
Mailing address
22825 N 102ND AVE, PEORIA, AZ 85383-2732
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5476
AZ
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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