Individual
LARRY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
PO BOX 707, ELEANOR, WV 25070-0707
(304) 533-2026
Mailing address
PO BOX 707, ELEANOR, WV 25070-0707
(304) 533-2026
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
40401
WV
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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