Provider Demographics
NPI:1275672479
Name:PHILLIPS, DOROTHY ELIZABETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ELIZABETH
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10849 BAL HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-4544
Mailing Address - Country:US
Mailing Address - Phone:561-251-2050
Mailing Address - Fax:561-210-7043
Practice Address - Street 1:10849 BAL HARBOR DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4544
Practice Address - Country:US
Practice Address - Phone:561-251-2050
Practice Address - Fax:561-210-7043
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18664225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist