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NPI 1649645094

NPI 1649645094 : NICOLE CURTIS MS, LAT, ATC : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1649645094
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLE CURTIS MS, LAT, ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/10/2015
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    Last Update Date     |    07/29/2019
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Provider Practice Location Address
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    Address Line         |    7173 FM 1628 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78263-9671
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    Country              |    US
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    Telephone            |    210-634-7100
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5001 BROOKHEAD LN 
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    City                 |    SCHERTZ
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    State                |    TX
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    Zip                  |    78108-2189
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    Country              |    US
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    Telephone            |    978-821-3993
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    AT6045
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    License Number State |    TX
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