Individual
JAMIE RUSSELL PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6171 W CHARLESTON BLVD, BLDG 14, LAS VEGAS, NV 89146-1126
(702) 486-0464
Mailing address
6171 W CHARLESTON BLVD, BLDG 14, LAS VEGAS, NV 89146-1126
(702) 486-0464
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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