Healthcare Provider Details

I. General information

NPI: 1053552372
Provider Name (Legal Business Name): CARA HOPE PHILLIPS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29100 GATEWAYS BLVD. SUITE 100
FLAT ROCK MI
48134
US

IV. Provider business mailing address

31231 FERNWOOD ST
WESTLAND MI
48186-5098
US

V. Phone/Fax

Practice location:
  • Phone: 734-379-9200
  • Fax: 734-379-9229
Mailing address:
  • Phone: 248-767-3063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009545
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: