Individual
MR. RONALD DALE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
7979 W RIFLEMAN ST, SUITE 100, BOISE, ID 83704-9066
(208) 377-3850
(208) 658-1360
Mailing address
7979 W RIFLEMAN ST, SUITE 100, BOISE, ID 83704-9066
(208) 377-3850
(208) 658-1360
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1938
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807223700
—
ID
Enumeration date
05/15/2006
Last updated
08/16/2011
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