MEDICARE: MS. SUSAN L. PHILLIPS A.P.

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	171100000X	Acupuncturist	A.P. 1520	FL

General Provider Information

NPI Number	:	1831391275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN L. PHILLIPS A.P.

Provider Business Mailing Address
First Line	:	3383 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2461
Country	:	US
Telephone Number	:	352-683-9499
Fax Number	:	352-666-2857

Provider Business Practice Location Address
First Line	:	3383 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2461
Country	:	US
Telephone Number	:	352-683-9499
Fax Number	:	352-666-2857

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	10/12/2017

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