Provider Demographics
NPI:1790256881
Name:PHILLIPS SCOLIOSIS CENTER
Entity Type:Organization
Organization Name:PHILLIPS SCOLIOSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-666-2526
Mailing Address - Street 1:375 W MAIN ST STE C1
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3683
Mailing Address - Country:US
Mailing Address - Phone:530-666-2526
Mailing Address - Fax:
Practice Address - Street 1:375 W MAIN ST STE C1
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3683
Practice Address - Country:US
Practice Address - Phone:530-666-2526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty