Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC002366-L | PA |
NPI | 1275576423 |
---|---|
Provider Name | Dr. William Robert Curran |
First Address | Glenside, PA 19038-4008 |
Second Address | Glenside, PA 19038-4008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0048476000 | PA BLUE CROSS (01) | PA |
T29212 | (02) | PA |