Healthcare Provider Details

I. General information

NPI: 1447244751
Provider Name (Legal Business Name): LISA M. CURRY A.T.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7621 LABYRINTH RD. PIKESVILLE HIGH SCHOOL
BALTIMORE MD
21208-4499
US

IV. Provider business mailing address

12211 PARK HEIGHTS AVE
OWINGS MILLS MD
21117-1013
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-1257
  • Fax:
Mailing address:
  • Phone: 410-356-6936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: