Healthcare Provider Details

I. General information

NPI: 1689974149
Provider Name (Legal Business Name): CURTIS GARRISON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2010
Last Update Date: 10/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 WASHINGTON ST PO BOX E
CONNEAUTVILLE PA
16406-7138
US

IV. Provider business mailing address

906 WASHINGTON ST PO BOX E
CONNEAUTVILLE PA
16406-7138
US

V. Phone/Fax

Practice location:
  • Phone: 814-373-2276
  • Fax: 814-587-2918
Mailing address:
  • Phone: 814-373-2276
  • Fax: 814-587-2918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT013302
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: