Provider Demographics
NPI:1003587817
Name:CURTIS, LUCY A (NRCMA, RPSGT, CCSH)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:A
Last Name:CURTIS
Suffix:
Gender:F
Credentials:NRCMA, RPSGT, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 PROMINENCE POINT PKWY STE 130-107
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-9077
Mailing Address - Country:US
Mailing Address - Phone:470-380-4634
Mailing Address - Fax:770-213-8461
Practice Address - Street 1:2128 COLONY DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-4520
Practice Address - Country:US
Practice Address - Phone:470-380-4634
Practice Address - Fax:770-213-8461
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7235156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist