Individual
MR. JEFFERY ALLEN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, CSAC
Contact information
Practice address
RR 6 BOX 540, GATE CITY, VA 24251-9760
(276) 452-1142
(276) 452-1140
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CSAC 0710101751
VA
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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