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NPI Code Detail

MEDICARE: RICHARD PHILLIPS LMT

MEDICARE: RICHARD PHILLIPS LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1316571359
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD PHILLIPS LMT
Provider Business Mailing Address
First Line : 4998 CLAYTON RD
Second Line :
City : BROOKVILLE
State : OH
Zip : 45309-8314
Country : US
Telephone Number : 937-830-5707
Fax Number :
Provider Business Practice Location Address
First Line : 5 N MAIN ST
Second Line :
City : ENGLEWOOD
State : OH
Zip : 45322-1326
Country : US
Telephone Number : 937-890-8660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2020
Last Update Date : 02/28/2020

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Directions to “ RICHARD PHILLIPS LMT” Practice Location

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