Individual
MR. CLIVE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6755 NW MONOCO CT, PORT ST LUCIE, FL 34983-5339
(772) 237-2496
(772) 237-2496
Mailing address
6755 NW MONOCO CT, PORT ST LUCIE, FL 34983-5339
(772) 237-2496
(772) 237-2496
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906987
FL
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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