Individual
MR. MARK ANDREW MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
236 W EDISON RD, SUITE F, MISHAWAKA, IN 46545-3184
(574) 255-1290
(574) 255-1523
Mailing address
14630 TRANQUIL CT, GRANGER, IN 46530-8301
(574) 255-1290
(574) 255-1523
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PENDING
IN
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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