Individual
MARY ELIZABETH PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DIETITIAN
Contact information
Practice address
404 JEFFERSON ST, PELLA, IA 50219-1257
(641) 628-3150
(641) 628-8901
Mailing address
404 JEFFERSON ST, PELLA, IA 50219-1257
(641) 628-3150
(641) 628-8901
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01700
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01700
LICENSE NUMBER
IA
Enumeration date
11/02/2006
Last updated
07/08/2007
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