JERAD MARTEL MILES

PRESCOTT, AZ
NPI1275193880
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: AZ  86144393)
Enumeration Date2019-06-17
Last Update Date2019-06-17
Business Address
JERAD MARTEL MILES RD
500 AZ-89
PRESCOTT, AZ 86301
Phone number: 928-445-4860
Mailing Address
JERAD MARTEL MILES RD
5700 MARKET ST APT 1055
PRESCOTT VALLEY, AZ 86314-6513
Phone number: 540-498-3007