Provider Demographics
NPI:1629524582
Name:PHILLIPS, IRENE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 E CAMELBACK RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3911
Mailing Address - Country:US
Mailing Address - Phone:602-241-1671
Mailing Address - Fax:602-274-6181
Practice Address - Street 1:4530 E RAY RD
Practice Address - Street 2:SUITE 125
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6094
Practice Address - Country:US
Practice Address - Phone:480-759-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other