Provider Demographics
NPI:1679845275
Name:PHILLIPS, MICHELLE V (MS, RCEP, CDE)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:V
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MS, RCEP, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 W MEMORIAL RD
Mailing Address - Street 2:INTENSIVE CARDIAC REHAB
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8382
Mailing Address - Country:US
Mailing Address - Phone:405-608-3200
Mailing Address - Fax:
Practice Address - Street 1:4050 W MEMORIAL RD
Practice Address - Street 2:INTENSIVE CARDIAC REHAB
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8382
Practice Address - Country:US
Practice Address - Phone:405-608-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist