Organization
LANA I PHILLIPS
Active
Other names
Ultra Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LANA I PHILLIPS (OWNER)
(304) 637-2567
Entity
Organization
Contact information
Practice address
328 MAIN ST, BEVERLY, WV 26253-9759
(304) 637-2567
Mailing address
328 MAIN ST, BEVERLY, WV 26253-9759
(304) 637-2567
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
070820
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009731
—
WV
Enumeration date
11/30/2007
Last updated
06/23/2008
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