Provider Demographics
NPI:1689884470
Name:PHILLIPS, MARGO JANET (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MARGO
Middle Name:JANET
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 BONNIE DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2309
Mailing Address - Country:US
Mailing Address - Phone:810-659-7546
Mailing Address - Fax:
Practice Address - Street 1:401 S BALLENGER HWY
Practice Address - Street 2:MCLAREN REGIONAL MEDICAL CENTER
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3685
Practice Address - Country:US
Practice Address - Phone:810-342-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000222225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist