Individual
KEVIN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
11038 GLENN WATTS RD, BATON ROUGE, LA 70818-3317
(225) 223-7967
Mailing address
11038 GLENN WATTS RD, BATON ROUGE, LA 70818-3317
(225) 223-7967
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA8124
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008821125
DRIVER LICENSE
LA
Enumeration date
03/22/2018
Last updated
03/22/2018
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