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NPI Code Detail

MEDICARE: PHILLIP EGAN

MEDICARE: PHILLIP EGAN
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
1235Z00000XSpeech-Language PathologistSLP.0001535CO

General Provider Information

NPI Number : 1912561317
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP EGAN
Provider Business Mailing Address
First Line : 815 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1844
Country : US
Telephone Number : 970-494-2140
Fax Number :
Provider Business Practice Location Address
First Line : 815 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1844
Country : US
Telephone Number : 970-494-2140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2019
Last Update Date : 05/01/2019

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Directions to “ PHILLIP EGAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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