Individual
REILLY F. PHILLIBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 581-2121
Mailing address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12985013-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/09/2020
Last updated
09/12/2022
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