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NPI 1366096331

NPI 1366096331 : DOINISHIA NATRECE PHILLIPS PTA : ALABASTER, AL

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General NPI Number Information
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    NPI Number           |    1366096331
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    Entity Type          |    Individual 
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    Provider Name        |    DOINISHIA NATRECE PHILLIPS PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/29/2019
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    Last Update Date     |    07/29/2019
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Provider Practice Location Address
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    Address Line         |    831 1ST ST N STE B 
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    City                 |    ALABASTER
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    State                |    AL
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    Zip                  |    35007-8944
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    Country              |    US
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    Telephone            |    205-358-9138
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    Fax                  |    205-358-9139
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Provider Business Mailing Address
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    Address Line         |    8205 PRESIDENTS DR FL 2 
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    City                 |    HUMMELSTOWN
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    State                |    PA
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    Zip                  |    17036-8621
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    Country              |    US
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    Telephone            |    717-839-2159
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    Fax                  |    717-565-1104
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    PTA9429
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    License Number State |    AL
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