Individual
LARRY PHILLIPS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3207 S 73RD DR, PHOENIX, AZ 85043-7230
(602) 314-0276
Mailing address
401 W WESTERN AVE UNIT 345, AVONDALE, AZ 85323-4414
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/10/2021
Last updated
04/10/2021
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