Provider Demographics
NPI:1740871607
Name:CURTIS, LAWRENCE DEAN (RPH)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:DEAN
Last Name:CURTIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7966 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-4446
Mailing Address - Country:US
Mailing Address - Phone:269-492-7156
Mailing Address - Fax:269-327-3904
Practice Address - Street 1:7966 LOVERS LN
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-4446
Practice Address - Country:US
Practice Address - Phone:269-492-7156
Practice Address - Fax:269-327-3904
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist