MEDICARE: DAVID V 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	1020	AZ

General Provider Information

NPI Number	:	1649274341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID V CURTIS RPT

Provider Business Mailing Address
First Line	:	1596 SUSAN A WILLIAMS WAY
Second Line	:	STE D
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-6120
Country	:	US
Telephone Number	:	480-380-4242
Fax Number	:	480-380-4240

Provider Business Practice Location Address
First Line	:	1596 SUSAN A WILLIAMS WAY
Second Line	:	STE D
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-6120
Country	:	US
Telephone Number	:	928-636-7950
Fax Number	:	928-636-7951

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	03/02/2016

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