Most Relevant Information
Provider Data
| NPI Number: | 1003483777 |
| Provider Name: | GENNI LEE MILLER LAT, ATC, PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 2081S0010X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | AT1256 |
Most Important Dates
| Enumeration Date: | 06/09/2021 |
| Last Updated: | 06/09/2021 |
Provider Practice Location
1210 CORINTH RD
JACKSONVILLE
TX
757663208
Practice Location Phone/Fax
| Phone: | 9035861704 |
| Fax: |
Provider Mailing Location
260 COUNTY ROAD 1518
JACKSONVILLE
TX
757666593
Provider Mailing Phone/Fax
| Phone: | 9037243232 |
| Fax: |