Provider Demographics
NPI:1023363363
Name:MORRISON PHILLIPS, CAROLYN (LMT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MORRISON PHILLIPS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N MIDVALE BLVD
Mailing Address - Street 2:SUITE 28
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5000
Mailing Address - Country:US
Mailing Address - Phone:608-320-9800
Mailing Address - Fax:
Practice Address - Street 1:222 N MIDVALE BLVD
Practice Address - Street 2:SUITE 28
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5000
Practice Address - Country:US
Practice Address - Phone:608-320-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10786-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist