Provider Demographics
NPI:1295065209
Name:PHIFER, ANGELA KAY (LAC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAY
Last Name:PHIFER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10339 CHAPMAN HWY, UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865
Mailing Address - Country:US
Mailing Address - Phone:865-250-7737
Mailing Address - Fax:865-333-5825
Practice Address - Street 1:10339 CHAPMAN HWY, UNIT 2
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865
Practice Address - Country:US
Practice Address - Phone:865-250-7737
Practice Address - Fax:865-333-5825
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU0000000153171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist