Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | ME91665 | FL |
NPI | 1629050547 |
---|---|
Provider Name | Mrs. Julie Curtis |
First Address | Weston, MA 02493-1321 |
Second Address | Weston, MA 02493-1321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 10/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E96947 | (02) | FL |