Provider Demographics
NPI:1689297228
Name:PHILLIPS, BRYCE STERLING (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:STERLING
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S CRESCENT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2910
Mailing Address - Country:US
Mailing Address - Phone:641-494-5180
Mailing Address - Fax:641-494-5185
Practice Address - Street 1:250 S CRESCENT DR STE 100
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2910
Practice Address - Country:US
Practice Address - Phone:641-494-5180
Practice Address - Fax:641-494-5185
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAUD.LD.61069669231H00000X, 237600000X
IA115615231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter