Provider Demographics
NPI:1750571279
Name:CURTIS, KRISTEN JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:JEAN
Last Name:CURTIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:JEAN
Other - Last Name:WOLVERTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:867 S MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-2432
Mailing Address - Country:US
Mailing Address - Phone:217-891-2399
Mailing Address - Fax:
Practice Address - Street 1:867 S MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-2432
Practice Address - Country:US
Practice Address - Phone:217-891-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor