Provider Demographics
NPI:1609993492
Name:PHILLIPS, CHRISTINE MARGARET (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARGARET
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:PO BOX 1742
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-1742
Mailing Address - Country:US
Mailing Address - Phone:435-655-2708
Mailing Address - Fax:435-655-2709
Practice Address - Street 1:1960 SIDEWINDER DR
Practice Address - Street 2:SUITE 206
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7329
Practice Address - Country:US
Practice Address - Phone:435-655-2708
Practice Address - Fax:435-655-2709
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT340384-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor