THEODORE PHILIP MILES

BLOOMINGTON, IN
NPI1013593342
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: IN  C2-1990)
Enumeration Date2021-03-18
Last Update Date2021-03-18
Business Address
MR. THEODORE PHILIP MILES CADAC II
1355 W BLOOMFIELD RD
BLOOMINGTON, IN 47403-2051
Phone number: 812-558-0574
Mailing Address
MR. THEODORE PHILIP MILES CADAC II
1355 W BLOOMFIELD RD
BLOOMINGTON, IN 47403-2051
Phone number: 812-558-0574
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