Provider Information for 1295073047
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KIM MILLER
Sex: Female
NPI: 1295073047
Last Updated: 2017-03-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1295073047 | ||||||||
| Enumeration Date | 2013-01-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1333 IRIS AVE BOULDER, CO 80304-2226 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 100 ATAPAHOE AVE #7 BOULDER, CO 80302 United States Phone: 303-818-0731 | Fax: | ||||||||
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