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General NPI Number Information
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NPI Number | 1548785124
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Entity Type | Individual
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Provider Name | THOMS DANIEL MILLER
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Gender | Male
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 1100 HENDERSON ST
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City | ARKADELPHIA
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State | AR
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Zip | 71999-0001
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Country | US
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Telephone | 870-230-5069
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Fax |
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Provider Business Mailing Address
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Address Line | 352 S VINE ST
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City | WEST UNION
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State | IA
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Zip | 52175-1437
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT
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License Number State | AR
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