Provider Demographics
NPI:1295767069
Name:CURTIS, BLAINE W (DC)
Entity type:Individual
Prefix:
First Name:BLAINE
Middle Name:W
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PARK ST STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2131
Mailing Address - Country:US
Mailing Address - Phone:207-596-6700
Mailing Address - Fax:
Practice Address - Street 1:147 PARK ST STE C
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2131
Practice Address - Country:US
Practice Address - Phone:207-596-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME129900099Medicaid
ME024090OtherPROVIDER NUMBER
ME129900100Medicaid
ME129900099Medicaid
ME129900100Medicaid