Individual
KEITH PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 VETERANS DR, HARRISBURG, IL 62946-3320
(618) 252-0275
(618) 252-2389
Mailing address
PO BOX 869, HARRISBURG, IL 62946-0869
(618) 252-0275
(618) 252-2389
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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