Individual
BONNIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 N. FODALE AVE., SOUTHPORT, NC 28461-2815
(910) 457-0830
Mailing address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(919) 424-5086
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5242
NC
Other
Enumeration date
11/24/2014
Last updated
11/25/2014
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