MEDICARE: DOROTHY CURTIS RPT

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	225100000X	Physical Therapist	3886	MA
2	225100000X	Physical Therapist	PT01055	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000031306	OTHER	MA	BCBSRI
2	402660	OTHER	MA	BCBSRI BLUE CHIP

General Provider Information

NPI Number	:	1205858370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY CURTIS RPT

Provider Business Mailing Address
First Line	:	45 HANDY ST
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-5820
Country	:	US
Telephone Number	:	508-226-1217
Fax Number	:

Provider Business Practice Location Address
First Line	:	1095 WASHINGTON ST
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-7944
Country	:	US
Telephone Number	:	508-761-9000
Fax Number	:	508-761-9111

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/08/2007

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