Provider Demographics
NPI:1396392189
Name:CURRIER, MARK
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:CURRIER
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 1:103 BRADFORD PL SE
Mailing Address - Street 2:
Mailing Address - City:POPLAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:61065-8780
Mailing Address - Country:US
Mailing Address - Phone:779-970-8710
Mailing Address - Fax:
Practice Address - Street 1:103 BRADFORD PL SE
Practice Address - Street 2:
Practice Address - City:POPLAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:61065-8780
Practice Address - Country:US
Practice Address - Phone:779-970-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider