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Individual

LARRY ROSS TRIPLETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS, CLINICIAN I

Contact information

Practice address
3105 E FAIRMOUNT AVE, PHOENIX, AZ 85016-6906
(602) 380-7544
Mailing address
202 E EARLL DR, SUITE 200, PHOENIX, AZ 85012-2647
(602) 599-5404
(602) 599-5704

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
11/19/2014
Last updated
11/19/2014
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