Individual
CARLA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5241 GARDENDALE AVE, DAYTON, OH 45417-8204
(937) 974-3582
Mailing address
5241 GARDENDALE AVE, DAYTON, OH 45417-8204
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
140941
OH
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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