Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1280446 | TX |
NPI | 1083166607 |
---|---|
Provider Name | Stacie Curtis |
First Address | Dallas, TX 75243-3845 |
Second Address | Dallas, TX 75243-3845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2016 |
Last Update Date | 31/10/2016 |