Healthcare Provider Details

I. General information

NPI: 1114362183
Provider Name (Legal Business Name): JAMES ALEXANDER PHILLIP D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W 2ND ST
ONSTED MI
49265-9455
US

IV. Provider business mailing address

1022 DEER VLY
MANCHESTER MI
48158-9482
US

V. Phone/Fax

Practice location:
  • Phone: 517-467-5466
  • Fax:
Mailing address:
  • Phone: 517-403-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010015
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: