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Individual
MR. WILLIE PHILLIPS II
Active
Individual
MR. WILLIE PHILLIPS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
LAT-3766
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000008378
NATABOC
CA
01
—
LAT-3766
NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
NC
Enumeration date
05/31/2018
Last updated
05/31/2018
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