Provider Demographics
NPI:1053552372
Name:PHILLIPS, CARA HOPE (DC)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:HOPE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31231 FERNWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5098
Mailing Address - Country:US
Mailing Address - Phone:248-767-3063
Mailing Address - Fax:
Practice Address - Street 1:29100 GATEWAYS BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134
Practice Address - Country:US
Practice Address - Phone:734-379-9200
Practice Address - Fax:734-379-9229
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor