Miller, Jesse Glenn

Miller, Jesse Glenn is an individual health care provider with primary practice located at 300 W Shawnee St Ste B , Muskogee OK 74401-4151. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Miller, Jesse Glenn can be contacted via phone (918) 683-9777.

Contact Information

Primary practice address
300 W Shawnee St Ste B Muskogee OK 74401-4151
Fax: (918) 683-9778
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3042 Oklahoma

Profile Details

NPI number 1720170517
LBN Legal business name Miller, Jesse Glenn
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Oct 2nd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720170517 NPPES
Oklahoma MEDICAID 100830610A

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