Individual
ALISSA MARIE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
321 ARCH ST STE 101, MEADVILLE, PA 16335-3214
(814) 333-7109
Mailing address
17661 MARSHALL RD, MEADVILLE, PA 16335-9775
(814) 573-9933
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RT006791
STATE BOARD OF MEDICINE
PA
Enumeration date
04/27/2016
Last updated
03/21/2023
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