Individual
GREGORY T KIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3820 S NOVA RD, PORT ORANGE, FL 32127-4949
(386) 767-0068
(386) 767-4755
Mailing address
3820 S NOVA RD, PORT ORANGE, FL 32127-4949
(386) 767-0068
(386) 767-4755
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1387
FL
Other
Enumeration date
05/25/2006
Last updated
11/07/2007
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