Organization
JACQUELINE PHILLIPS DPM INC
Active
Parent organization
JACQUELINE PHILLIPS DPM INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACQUELINE PHILLIPS DPM INC
Authorized official
JACQUELINE PHILLIPS DPM (PRESIDENT)
(313) 345-4449
Entity
Organization
Contact information
Practice address
5575 CONNER ST, SUITE 203, DETROIT, MI 48213-6400
(313) 345-4449
(313) 499-8341
Mailing address
5575 CONNER ST, SUITE 203, DETROIT, MI 48213-6400
(313) 345-4449
(313) 499-8341
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5901001422
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255320495
—
MI
Enumeration date
03/22/2012
Last updated
03/22/2012
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