Individual
ADAM PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2202 N BROADWAY ST, POTEAU, OK 74953-2000
(918) 649-0018
Mailing address
401 N CHURCH ST, POTEAU, OK 74953-3502
(918) 649-0230
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10220
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/06/2016
Last updated
08/16/2021
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