Provider Demographics
NPI:1609182278
Name:PHILLIPS, RENEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HEARTHSTONE CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-3065
Mailing Address - Country:US
Mailing Address - Phone:610-685-1761
Mailing Address - Fax:610-370-2740
Practice Address - Street 1:6 HEARTHSTONE CT
Practice Address - Street 2:SUITE 200
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-3065
Practice Address - Country:US
Practice Address - Phone:610-685-1761
Practice Address - Fax:610-370-2740
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist