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Individual

CASEY MICHELLE PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
592 W OMAHA AVE, CLOVIS, CA 93619-4805
(559) 593-2456
Mailing address
592 W OMAHA AVE, CLOVIS, CA 93619-4805
(559) 593-2456

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
01/12/2010
Last updated
01/12/2010
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