Individual
JESSE K MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, PTA
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
Mailing address
925 S EAST ST, CROWN POINT, IN 46307-4908
(812) 595-5759
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004554A
IN
Other
Enumeration date
09/22/2021
Last updated
09/25/2023
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