Individual provider · NPI-1

Garry Owen Miller, AT

Specialist/Technologist, Athletic Trainer · Lorain, OH

NPI number1528386646
StatusActive
Last updated in NPPESMay 13, 2010

Details

NPI
1528386646
Entity type
Individual (NPI-1)
Name
Mr. Garry Owen Miller
Credential
AT
Sex
Male
Sole proprietor
No
Enumeration date
May 13, 2010
Last updated
May 13, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer0000107OHYes

Practice location

3107 E Erie Ave
Lorain, OH 44052-2549

Phone 216-312-9545

Mailing address

3107 E Erie Ave
Lorain, OH 44052-2549

Phone 216-312-9545

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