Healthcare Provider Details

I. General information

NPI: 1952239568
Provider Name (Legal Business Name): MICHAEL CURTISS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 W 1500 N
LEHI UT
84048-7130
US

IV. Provider business mailing address

1800 NOVELL PL
PROVO UT
84606-6171
US

V. Phone/Fax

Practice location:
  • Phone: 406-291-7581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: