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General NPI Number Information
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NPI Number | 1063601573
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Entity Type | Organization
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Legal Business Name | KEVIN MILES, D.O., LTD.
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Dates
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Enumeration Date | 10/20/2007
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Last Update Date | 12/31/2015
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Provider Practice Location Address
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Address Line | 890 MILL ST SUITE 102
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City | RENO
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State | NV
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Zip | 89502-1442
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Country | US
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Telephone | 775-324-6300
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Fax | 775-324-6301
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Provider Business Mailing Address
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Address Line | PO BOX 17418
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City | RENO
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State | NV
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Zip | 89511-7418
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Country | US
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Telephone | 775-324-6300
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Fax | 775-324-6301
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVIN MILES
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Credential | D.O.
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Telephone | 775-324-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 1221
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License Number State | NV
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