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Individual

MR. JEFFERY LUKE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA/L, ATP

Contact information

Practice address
100 NETHERLAND LN, KINGSPORT, TN 37660-7245
(423) 245-0360
Mailing address
3441 HIGHWAY 126, BLOUNTVILLE, TN 37617-4525
(423) 844-0939

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
01231
TN

Other

Enumeration date
03/27/2019
Last updated
03/27/2019
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