Individual
DENIA M PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1200 LAKE HEARN DR NE, SUITE 250, ATLANTA, GA 30319-1415
(404) 943-1070
(404) 943-0890
Mailing address
2466 LOST VALLEY TRL SE, CONYERS, GA 30094-2437
(770) 712-1001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049095452
DRIVER'S LICENSE
GA
Enumeration date
04/14/2011
Last updated
04/14/2011
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