NPI 1063283463

Shane T Phillips, MEDATCLPES

Practitioner Athletic Trainer Anchorage, AK

Practice location

Address: 5955 Zeamer Ave, Anchorage, AK 99506-3702
Phone: (907) 580-2778
Mailing address: 4610 Reka Dr APT A19, Anchorage, AK 99508-3614

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 123978 (IA)

Other Specialist/Technologist providers in Alaska →

Registry record

NPI: 1063283463
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jan 2024
Record last updated: 15 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.