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General NPI Number Information
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NPI Number | 1871127548
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Entity Type | Individual
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Provider Name | HANNAH GRACE MILLER ATC
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Gender | Female
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 21 GRAHAM AVE
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City | CORTLAND
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State | NY
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Zip | 13045-2452
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Country | US
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Telephone | 802-318-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 13 LINCOLN AVE APT 1
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City | CORTLAND
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State | NY
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Zip | 13045-2068
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Country | US
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Telephone | 802-318-3627
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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 | 004965
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License Number State | NY
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