Individual
MR. JOEL M PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
2297 S 9TH ST, KALAMAZOO, MI 49009-9462
(269) 377-5594
(888) 594-4367
Mailing address
2297 S 9TH ST, KALAMAZOO, MI 49009-9462
(269) 377-5594
(888) 594-4367
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5201006390
MI
225XH1200X
Hand Occupational Therapist
5201006390
MI
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5201006390
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023052412
NPI
MI
01
—
155812
GREAT LAKES HLTH PLN
—
01
—
OP15760
MEDICARE PTAN
MI
Enumeration date
06/15/2006
Last updated
12/27/2022
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