Individual
VICKIEJEAN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1332 35TH ST, SPRINGFIELD, OR 97478-5554
(503) 851-9055
Mailing address
1332 35TH ST, SPRINGFIELD, OR 97478-5554
(503) 851-9055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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