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NPI Code Detail

MEDICARE: CURTIS FLOYD FORST MPA-C

MEDICARE:   CURTIS FLOYD FORST  MPA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9426MN

General Provider Information

NPI Number : 1073501599
Entity Type Code : Individual
Provider Name (Legal Business Name) : CURTIS FLOYD FORST MPA-C
Provider Business Mailing Address
First Line : 1805 HENNEPIN AVE N
Second Line :
City : GLENCOE
State : MN
Zip : 55336-1416
Country : US
Telephone Number : 320-864-3121
Fax Number : 320-864-7887
Provider Business Practice Location Address
First Line : 1805 HENNEPIN AVE N
Second Line :
City : GLENCOE
State : MN
Zip : 55336-1416
Country : US
Telephone Number : 320-864-3121
Fax Number : 320-864-7887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 07/08/2007

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Directions to “ CURTIS FLOYD FORST MPA-C” Practice Location

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