| Doctor Name: | MARY ALICE PHILLIPS |
| NPI Number: | 1467470476 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | |
| Business Practice Address: | 1600 Specht Point Rd Ste 127 Ft Collins, CO - 80525 |
| Business Phone Number: | 9704937878 |
| Business Fax Number: | 9704932682 |
| Mailing Address: | 1600 Specht Point Rd, Ste 127 FT COLLINS |
| State: | CO |
| Postal Code: | 80525 |
| Phone Number: | 9704937878 |
| Fax Number: | 9704932682 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 04/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1005X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Renal |
| Taxonomy Definition: | |