Provider Demographics
NPI:1588224588
Name:MINNICK, CURTIS WILLIAM
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:WILLIAM
Last Name:MINNICK
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 1:2013 LEGAT LN
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-3332
Mailing Address - Country:US
Mailing Address - Phone:610-506-7883
Mailing Address - Fax:215-256-0439
Practice Address - Street 1:2013 LEGAT LN
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-3332
Practice Address - Country:US
Practice Address - Phone:610-506-7883
Practice Address - Fax:215-256-0439
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032433L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist