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General NPI Number Information
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NPI Number | 1043708688
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Entity Type | Individual
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Provider Name | LAURA JO MILLER RPH
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Gender | Female
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 9101 OHIO RIVER RD
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City | WHEELERSBURG
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State | OH
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Zip | 45694-1927
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Country | US
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Telephone | 740-574-6569
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Fax | 740-574-6728
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Provider Business Mailing Address
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Address Line | 6414 N STATE ROUTE 139
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City | LUCASVILLE
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State | OH
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Zip | 45648-8635
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Country | US
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Telephone | 740-456-5167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03322061
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License Number State | OH
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