MEDICARE: MR. CURTIS WAYNE CRAFT SR.

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
1	2278P4000X	Patient Transport Certified Respiratory Therapist

General Provider Information

NPI Number	:	1083466585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CURTIS WAYNE CRAFT SR.

Provider Business Mailing Address
First Line	:	2709 CLUB HOUSE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-1715
Country	:	US
Telephone Number	:	614-597-5487
Fax Number	:

Provider Business Practice Location Address
First Line	:	2709 CLUB HOUSE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-1715
Country	:	US
Telephone Number	:	614-597-5487
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2024
Last Update Date	:	04/05/2024

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