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Individual

SHANE T PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MED, ATC/L, PES

Contact information

Practice address
5955 ZEAMER AVE, ANCHORAGE, AK 99506-3702
(907) 580-2778
Mailing address
4610 REKA DR APT A19, ANCHORAGE, AK 99508-3614
(303) 883-6151

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
123978
IA

Other

Enumeration date
01/15/2024
Last updated
01/15/2024
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