Individual
MITZI ELAINE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6985 NUGGETT DR, MORGANTON, NC 28655-7994
(828) 443-3185
Mailing address
6985 NUGGETT DR, MORGANTON, NC 28655-7994
(828) 443-3185
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
1883
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1883
PHYCSICAL THERAPIST ASSISTANT
NC
Enumeration date
06/13/2013
Last updated
06/13/2013
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