Individual
MRS. JUSTINE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6731 ALAMO WAY, LA MESA, CA 91942-5807
(714) 504-3478
Mailing address
6731 ALAMO WAY, LA MESA, CA 91942-5807
(714) 504-3478
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
2000040731
CA
2255A2300X
Athletic Trainer
Primary
BOC381720
CA
Other
Enumeration date
03/07/2021
Last updated
03/11/2021
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