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Individual

DR. KENTSTON CRIPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2103 FOREST AVE, CHICO, CA 95928-7680
(530) 895-3668
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5846
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100255147
CA
Enumeration date
04/09/2019
Last updated
01/26/2023
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