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General NPI Number Information
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NPI Number | 1457599011
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Entity Type | Individual
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Provider Name | NOELLE PHILLIPS PT
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Gender | Female
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 5650 S WASHINGTON AVE PARRISH PEDIATRIC REHAB
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City | TITUSVILLE
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State | FL
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Zip | 32780-7312
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Country | US
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Telephone | 321-360-9288
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Fax | 321-456-9906
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Provider Business Mailing Address
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Address Line | 1917 NEWFOUND HARBOR DR
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-2844
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Country | US
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Telephone | 407-227-7781
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Fax | 321-456-9906
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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 | PT24252
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License Number State | FL
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