Individual
MR. BRIAN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.S.
Contact information
Practice address
1372 BENBRANDON CT, ONTARIO, OH 44906-3239
(419) 545-4864
Mailing address
1372 BENBRANDON CT, ONTARIO, OH 44906-3239
(419) 545-4864
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
SH946006
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03082021282725
—
OH
05
—
594519
—
OH
Enumeration date
01/20/2022
Last updated
01/20/2022
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