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Individual

VERNON WESLEY CRISP JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4530 E MUIRWOOD DR, SUITE 110, PHOENIX, AZ 85048-7639
(480) 763-5808
(480) 759-0647
Mailing address
PO BOX 52817, PHOENIX, AZ 85072-2817
(480) 763-5808
(480) 759-0647

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
05395
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4375
AZ
208100000X
Physical Medicine & Rehabilitation Physician
47184
MN
208100000X
Physical Medicine & Rehabilitation Physician
OS 9787
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
348620600
MN
Enumeration date
01/17/2006
Last updated
01/13/2010
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