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General NPI Number Information
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NPI Number | 1457588550
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Entity Type | Individual
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Provider Name | KALI A PHILLIPS DPT
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Gender | Female
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 8396 SIX FORKS RD SUITE 102
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City | RALEIGH
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State | NC
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Zip | 27615-3058
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Country | US
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Telephone | 919-841-4930
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Fax | 919-841-4933
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Provider Business Mailing Address
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Address Line | 8396 SIX FORKS RD SUITE 102
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City | RALEIGH
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State | NC
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Zip | 27615-3058
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Country | US
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Telephone | 919-841-4930
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Fax | 919-841-4933
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 12204
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License Number State | NC
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