Individual
PHILLIP RAY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
182 OLD CABIN DR, 182 OLD CABIN DRIVE, GLIDE, OR 97443-9750
(541) 496-0013
Mailing address
182 OLD CABIN DR, 182 OLD CABIN DRIVE, GLIDE, OR 97443-9750
(541) 496-0013
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200050016
OR
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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