Individual
LAURIE A PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 CHASE, CORDOVA, AK 99574
(907) 424-8300
Mailing address
PO BOX 160, CORDOVA, AK 99574-0160
(907) 424-8300
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM4795
—
AK
Enumeration date
01/23/2008
Last updated
01/23/2008
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