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General NPI Number Information
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NPI Number | 1225856016
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Entity Type | Individual
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Provider Name | ANGELA PHILLIPS PT
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 6136 STATE HIGHWAY 1056
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City | RANSOM
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State | KY
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Zip | 41558-8401
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Country | US
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Telephone | 606-369-4644
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35
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City | MC CARR
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State | KY
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Zip | 41544-0035
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Country | US
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Telephone | 606-369-4464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003543
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003262
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License Number State | WV
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