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Jack Miller

NPI 1528444304 · on the registry since 2015 · sole proprietor

Practice

Address
1262 S. Conwell Stc
Casper, WY 82601
Phone
(303) 829-3800

Registry record

Primary taxonomy
183500000X
183500000X
Also registered as
183500000X
Licence states on file
WY, CO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2015-08-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming