MEDICARE: DEBORAH PHILLIPS OTR

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
1	225X00000X	Occupational Therapist	5201000601	MI

General Provider Information

NPI Number	:	1437267895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH PHILLIPS OTR

Provider Business Mailing Address
First Line	:	1314 MOREY HWY
Second Line	:
City	:	CLAYTON
State	:	MI
Zip	:	49235-9696
Country	:	US
Telephone Number	:	517-445-2841
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 W MAUMEE ST
Second Line	:	SUITE 3
City	:	ADRIAN
State	:	MI
Zip	:	49221-1899
Country	:	US
Telephone Number	:	517-265-6007
Fax Number	:	517-265-5930

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2006
Last Update Date	:	07/08/2007

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Directions to “ DEBORAH PHILLIPS OTR” Practice Location

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