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General NPI Number Information
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NPI Number | 1306830237
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Entity Type | Individual
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Provider Name | CHERRYANNE MARIE PHILLIPS PT
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Gender | Female
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12341 NW 18TH ST
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City | PLANTATION
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State | FL
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Zip | 33323-2122
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Country | US
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Telephone | 954-478-4648
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Fax | 954-530-5694
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Provider Business Mailing Address
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Address Line | 11725 NW 11TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4340
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Country | US
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Telephone | 954-257-4968
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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 | PT18433
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License Number State | FL
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