Provider Demographics
NPI:1376184382
Name:CURTIS, HEATHER JO
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:JO
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 JOHNSON STREET RD
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-2219
Mailing Address - Country:US
Mailing Address - Phone:319-795-6795
Mailing Address - Fax:
Practice Address - Street 1:1115 JOHNSON STREET RD
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-2219
Practice Address - Country:US
Practice Address - Phone:319-795-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant