| Doctor Name: | MR. KELLY MILLER |
| NPI Number: | 1447384086 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.D., L.D. |
| License Number: | LD692 |
| Business Practice Address: | 1800 W University Blvd Durant, OK - 747013006 |
| Business Phone Number: | 5809312020 |
| Business Fax Number: | 5809312048 |
| Mailing Address: | 287 Evergreen Ln, MEAD |
| State: | OK |
| Postal Code: | 734495111 |
| Phone Number: | 5809202560 |
| Fax Number: | |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | LD692 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |