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General NPI Number Information
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NPI Number | 1528768421
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Entity Type | Individual
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Provider Name | PAMELA PHILLIPS DC
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 780 BAYOU PINES EAST DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7184
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Country | US
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Telephone | 337-421-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 5640 AUTUMN LN
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City | LAKE CHARLES
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State | LA
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Zip | 70605-6563
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Country | US
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Telephone |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1977
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License Number State | LA
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