MEDICARE: DAISY KAE MILLER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2022025975	MO

General Provider Information

NPI Number	:	1881329464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISY KAE MILLER OD

Provider Business Mailing Address
First Line	:	4801 S CLIFF AVE STE 100
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64055-6954
Country	:	US
Telephone Number	:	816-350-4536
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 NW STATE ROUTE 7
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-6401
Country	:	US
Telephone Number	:	816-350-5027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	07/19/2022

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