Provider Demographics
NPI:1043432040
Name:CURRIE, MICHAEL BRENT (DC BSN)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRENT
Last Name:CURRIE
Suffix:
Gender:M
Credentials:DC BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55416 MELTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411
Mailing Address - Country:US
Mailing Address - Phone:541-347-3408
Mailing Address - Fax:541-347-3408
Practice Address - Street 1:55416 MELTON ROAD
Practice Address - Street 2:
Practice Address - City:BANDON
Practice Address - State:OR
Practice Address - Zip Code:97411
Practice Address - Country:US
Practice Address - Phone:541-347-3408
Practice Address - Fax:541-347-3408
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 2264111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT81836Medicare UPIN
OR118434Medicare PIN
OR118436Medicare PIN