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1528587680
JACK PHILIP MILLER
FORT WAYNE, IN
NPI
1528587680
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-09-11
Last Update Date
2017-09-11
Business Address
JACK PHILIP MILLER
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-482-9125
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Mailing Address
JACK PHILIP MILLER
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number:
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