Individual
KYLE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SO-IDC
Contact information
Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
(910) 907-2575
Mailing address
365 W ILLINOIS AVE, SOUTHERN PINES, NC 28387-5846
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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