Provider Demographics
NPI:1720145329
Name:CURTIS B DUBOISE PT PC
Entity Type:Organization
Organization Name:CURTIS B DUBOISE PT PC
Other - Org Name:CURTIS B DUBOIS AND ASSOCIATES PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PT PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-731-2195
Mailing Address - Street 1:2111 SAWYER DR
Mailing Address - Street 2:
Mailing Address - City:NIAGRA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304
Mailing Address - Country:US
Mailing Address - Phone:716-731-2195
Mailing Address - Fax:716-731-4862
Practice Address - Street 1:2111 SAWYER DR
Practice Address - Street 2:
Practice Address - City:NIAGRA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304
Practice Address - Country:US
Practice Address - Phone:716-731-2195
Practice Address - Fax:716-731-4862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0192Medicare ID - Type Unspecified