Individual
DOUGLAS BRENT PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10301 KANIS RD, LITTLE ROCK, AR 72205-6205
(501) 604-6913
Mailing address
35 SPRINGRIDGE DR, LITTLE ROCK, AR 72211-5431
(205) 657-6984
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
608
AR
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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