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General NPI Number Information
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NPI Number | 1619007747
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Entity Type | Individual
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Provider Name | CHRIS PHILLIPS PT
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 4519 N GARFIELD ST SUITE 5
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City | MIDLAND
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State | TX
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Zip | 79705-3415
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Country | US
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Telephone | 432-570-8782
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Fax | 432-683-8476
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Provider Business Mailing Address
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Address Line | 1563 E 49TH ST
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City | ODESSA
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State | TX
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Zip | 79762-4401
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Country | US
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Telephone | 432-570-8782
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Fax | 432-683-8476
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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 | 1114411
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License Number State | TX
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