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Ms. Dana Miller
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NPI Number Detailed Information
Provider Information:
Name: | Ms. Dana Miller |
Gender: | F |
Provider License Number If Given: | 15-00376 |
NPI Information:
NPI: | 1366441883 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 7/18/2005 |
Last Update Date: | 2/3/2016 |
Provider Business Mailing Address:
Address: | 30 VINEYARD HAVEN DR Pooler, GA 31322 |
Phone Number: | 9129202182 |
Fax Number: |
Provider Business Practice Location Address:
Address: | 1061 HARMON AVE Fort Stewart, GA 31314 |
Phone Number: | 9124356666 |
Fax Number: |
Provider Taxonomy:
Primary: | 363A00000X |
Secondary (if any): | |
State: | GA |