Phillips, Willie

Phillips, Willie is an individual health care provider with primary practice located at 1900 Selwyn Ave , Charlotte NC 28274-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Phillips, Willie can be contacted via phone (704) 337-2405.

Contact Information

Primary practice address
1900 Selwyn Ave Charlotte NC 28274-0001
Phone: (704) 337-2405
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X LAT-3766 North Carolina

Profile Details

NPI number 1154813756
LBN Legal business name Phillips, Willie
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2018
Last updated May 31st, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154813756 NPPES
North Carolina Other LAT-3766 NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
North Carolina Other 2000008378 NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS

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