Organization
PHILLIPS FOOT CLINIC
Active
Other names
PHILLIPS FOOT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE PHILLIPS DPM (PRESIDENT)
(313) 499-8307
Entity
Organization
Contact information
Practice address
5575 CONNER ST, SUITE 203, DETROIT, MI 48213-6400
(313) 499-8307
Mailing address
5575 CONNER ST, SUITE 203, DETROIT, MI 48213-6400
(313) 499-8307
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001422
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821027756
—
MI
Enumeration date
12/31/2014
Last updated
02/18/2015
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