Individual
MARDELL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2606 GOLDEN EAGLE DR, SIERRA VISTA, AZ 85650-6865
(520) 227-7547
Mailing address
2606 GOLDEN EAGLE DR, SIERRA VISTA, AZ 85650-6865
(520) 227-7547
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-18948
AZ
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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