Individual
MR. LOUIS IRVIN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.T.
Contact information
Practice address
167 N. MAIN ST., TUBA CITY, AZ 86045-0600
(928) 283-2501
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
451503
MN
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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