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General NPI Number Information
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NPI Number | 1285044115
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Entity Type | Organization
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Legal Business Name | GLENN E. CRIPE, DC, INC
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 1501 WESTCLIFF DR SUITE 210
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5517
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Country | US
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Telephone | 949-631-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 WESTCLIFF DR SUITE 210
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5517
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLENN CRIPE
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Credential |
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Telephone | 949-631-5171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC12646
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License Number State | CA
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