Individual
PHILLIP L DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1140 M ST, GREELEY, CO 80631-9586
(970) 313-1173
Mailing address
PO BOX 200239, EVANS, CO 80620-0239
(720) 546-1668
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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