Provider Demographics
NPI:1316026909
Name:PHILLIPS, ANDREA DIANE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:DIANE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 S 88TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9418
Mailing Address - Country:US
Mailing Address - Phone:303-665-9549
Mailing Address - Fax:303-665-9546
Practice Address - Street 1:1044 S 88TH ST STE 109
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9418
Practice Address - Country:US
Practice Address - Phone:303-665-9549
Practice Address - Fax:303-665-9546
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK457111N00000X
NJ38MC00800200111N00000X
CO6268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor