Provider Demographics
NPI:1366015893
Name:GOINS, CURTIS ALAN
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:ALAN
Last Name:GOINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TODD ST APT 15
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-1951
Mailing Address - Country:US
Mailing Address - Phone:501-333-4047
Mailing Address - Fax:
Practice Address - Street 1:601 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060-1201
Practice Address - Country:US
Practice Address - Phone:563-652-4064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY269942225X00000X
IA110041225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist