Individual
JUSTIN ERIC MCMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1255 SWALLOW LN, FLORISSANT, MO 63031-3326
(314) 359-3531
Mailing address
1255 SWALLOW LN, FLORISSANT, MO 63031-3326
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2017008455
MO
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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