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General NPI Number Information
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NPI Number | 1295956407
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Entity Type | Individual
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Provider Name | CURTIS I BIRKY PHD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7139 114TH AVE
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City | GLENN
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State | MI
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Zip | 49416
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Country | US
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Telephone | 269-227-0004
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 331
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City | GLENN
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State | MI
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Zip | 49416
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Country | US
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Telephone | 269-227-3503
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801073463
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34000562A
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License Number State | IN
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