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1770107179
DERRICK CHRISTOPHER PENTICUFF
PUEBLO, CO
NPI
1770107179
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2020-06-01
Last Update Date
2023-04-12
Business Address
DERRICK CHRISTOPHER PENTICUFF
4115 CLUB MANOR DR
PUEBLO, CO 81008
Phone number: 968-568-9790
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Mailing Address
DERRICK CHRISTOPHER PENTICUFF
4115 CLUB MANOR DR.
PUEBLO, CO 81008
Phone number: 417-709-5228
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