Individual
BEAU MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 MISSION ROAD, GLENDALE, CA 91205
(310) 924-5853
Mailing address
330 MISSION RD., GLENDALE, CA 91205
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 9620
CA
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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