Provider Demographics
NPI:1588860514
Name:PHILLIPS, REBECCA KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:KAY
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 1:10801 LOMAS BLVD NE
Mailing Address - Street 2:STE. 103
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-5401
Mailing Address - Country:US
Mailing Address - Phone:505-291-9800
Mailing Address - Fax:505-299-6282
Practice Address - Street 1:10801 LOMAS BLVD NE
Practice Address - Street 2:STE. 103
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5401
Practice Address - Country:US
Practice Address - Phone:505-291-9800
Practice Address - Fax:505-299-6282
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1174111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor