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1013235241
DERRICK N CRUMPLER
ELK GROVE, CA
NPI
1013235241
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2010-05-12
Last Update Date
2010-05-12
Business Address
DERRICK N CRUMPLER DIRECT SERVICE PROVI
5823 FIRE POPPY DR
ELK GROVE, CA 95757-2848
Phone number: 916-247-6058
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Mailing Address
DERRICK N CRUMPLER DIRECT SERVICE PROVI
5823 FIRE POPPY DR
ELK GROVE, CA 95757-2848
Phone number: 916-247-6058
Copy