Individual
MRS. SUSAN LEA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
23 MASON ST, LAUREL, MS 39440-4437
(601) 399-0534
(601) 399-2810
Mailing address
926 PAULDING RD, ELLISVILLE, MS 39437-5100
(601) 580-5027
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1423
MS
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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