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General NPI Number Information
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NPI Number | 1275699761
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Entity Type | Individual
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Provider Name | WENDY ELLEN PHILLIPS PH.D., P.T.
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 444 CLAIRE DR NE
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City | ATLANTA
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State | GA
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Zip | 30307-1828
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Country | US
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Telephone | 404-798-1961
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Fax | 494-377-9799
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Provider Business Mailing Address
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Address Line | 444 CLAIRE DR NE
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City | ATLANTA
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State | GA
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Zip | 30307-1828
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Country | US
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Telephone | 404-798-1961
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Fax | 494-377-9799
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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 | 002512
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License Number State | GA
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