Healthcare Provider Details

I. General information

NPI: 1861404808
Provider Name (Legal Business Name): CURTIS C HILDEBRANDT DPT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CROSSLAKE DR
EVANSVILLE IN
47715-8198
US

IV. Provider business mailing address

7300 E INDIANA ST SUITE 102
EVANSVILLE IN
47715-2794
US

V. Phone/Fax

Practice location:
  • Phone: 812-471-6677
  • Fax: 812-474-2296
Mailing address:
  • Phone: 812-476-0409
  • Fax: 812-476-1016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36001310A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05010703A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: