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1154990638
MICHAEL PHILLIPS
SHREVEPORT, LA
NPI
1154990638
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-06-21
Last Update Date
2021-06-21
Business Address
MICHAEL PHILLIPS
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0434
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Mailing Address
MICHAEL PHILLIPS
1501 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0434
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