Most Relevant Information
Provider Data
| NPI Number: | 1003055666 |
| Provider Name: | JUSTIN MICHAEL MILLER PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 0010-01677 |
Most Important Dates
| Enumeration Date: | 02/05/2009 |
| Last Updated: | 05/16/2014 |
Provider Practice Location
1111 LEFFINGWELL AVE NE
GRAND RAPIDS
MI
495256406
Practice Location Phone/Fax
| Phone: | 6164597101 |
| Fax: |
Provider Mailing Location
1111 LEFFINGWELL AVE NE
GRAND RAPIDS
MI
495256406
Provider Mailing Phone/Fax
| Phone: | 6164597101 |
| Fax: | 6169546483 |