Individual
SUSAN RAND PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
18A HIGH ST, WINTHROP, ME 04364
(207) 377-9400
(207) 377-3385
Mailing address
18A HIGH ST, WINTHROP, ME 04364
(207) 377-9400
(207) 377-3385
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT9400
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004625
BC/BS
ME
05
—
123230000
—
ME
Enumeration date
03/31/2006
Last updated
06/07/2012
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