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General NPI Number Information
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NPI Number | 1346842978
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Entity Type | Individual
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Provider Name | TRACEY LEE CURTIS DC
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Gender | Female
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 2307 LAPORTE AVE STE 10
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City | VALPARAISO
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State | IN
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Zip | 46383-6997
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Country | US
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Telephone | 219-510-5623
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Fax |
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Provider Business Mailing Address
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Address Line | 2166 CRISMAN RD
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City | PORTAGE
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State | IN
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Zip | 46368-2102
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Country | US
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Telephone | 314-685-9992
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08003188A
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License Number State | IN
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