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Organization
PHILLIPS FOOT CLINIC
Active
Organization
PHILLIPS FOOT CLINIC
Active
Other names
PHILLIPS FOOT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE PHILLIPS DPM (PRESIDENT)
(313) 499-8307
Entity
Organization
Contact information
Practice address
5575 CONNER ST, SUITE 203, DETROIT, MI 48213-6400
(313) 499-8307
Mailing address
5575 CONNER ST, SUITE 203, DETROIT, MI 48213-6400
(313) 499-8307
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001422
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821027756
—
MI
Enumeration date
12/31/2014
Last updated
02/18/2015
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