Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | 7235 | MA |
NPI | 1003587817 |
---|---|
Provider Name | Lucy A Curtis |
First Address | Canton, GA 30114-9077 |
Second Address | Canton, GA 30114-4520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2021 |
Last Update Date | 22/09/2021 |