Provider Demographics
NPI:1518591148
Name:PHILLIPS, HAYLEY B (PT DPT)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:B
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:L
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:449 N. WENDOVER ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211
Mailing Address - Country:US
Mailing Address - Phone:704-366-7723
Mailing Address - Fax:704-366-7724
Practice Address - Street 1:449 N. WENDOVER ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-366-7723
Practice Address - Fax:704-366-7724
Is Sole Proprietor?:No
Enumeration Date:2020-02-22
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NCP19374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist