Individual
CHANTELLE NICOLE CRENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 372-6789
Mailing address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 227-2016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
OK
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
08/21/2024
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