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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

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