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General NPI Number Information
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NPI Number | 1295206415
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Entity Type | Individual
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Provider Name | JAMIE LYNN MILLER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 2110 16TH ST
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City | BAY CITY
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State | MI
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Zip | 48708-7609
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Country | US
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Telephone | 989-522-5899
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Fax |
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Provider Business Mailing Address
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Address Line | 718 S GRANT ST
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City | BAY CITY
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State | MI
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Zip | 48708-7307
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201007314
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License Number State | MI
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