Individual
SUZANNE M PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2150 STADIUM DR, BOULDER, CO 80309-0001
(303) 315-9900
(303) 415-9902
Mailing address
5450 WESTERN AVE, BOULDER, CO 80301-2709
(303) 315-9900
(303) 315-9902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTL.0003355
CO
2251S0007X
Sports Physical Therapist
Primary
PTL.0003355
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43026206
—
CO
Enumeration date
06/02/2008
Last updated
11/09/2017
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