Provider Demographics
NPI:1295180990
Name:PHILLIPS, ALLISON RUTH (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:RUTH
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:RUTH
Other - Last Name:NISBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:104 N ALLEN AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2217
Mailing Address - Country:US
Mailing Address - Phone:626-346-0977
Mailing Address - Fax:
Practice Address - Street 1:104 N ALLEN AVE APT 1
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2217
Practice Address - Country:US
Practice Address - Phone:626-346-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34009111N00000X
IN08002902A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor