Provider Demographics
NPI:1477741643
Name:CURTIS, SUSAN DIANE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DIANE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55432 COLBY ST
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-8701
Mailing Address - Country:US
Mailing Address - Phone:269-782-7828
Mailing Address - Fax:269-783-3400
Practice Address - Street 1:55432 COLBY ST
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-8701
Practice Address - Country:US
Practice Address - Phone:269-782-7828
Practice Address - Fax:269-783-3400
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004692A225100000X
MI5501005019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist