Provider Demographics
NPI:1801877477
Name:CURTIN, MICHAEL (DPT,MS, OCS, FAAOMPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CURTIN
Suffix:
Gender:M
Credentials:DPT,MS, OCS, FAAOMPT
Other - Prefix:DR
Other - First Name:MIKE
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT,MS, OCS, FAAOMPT
Mailing Address - Street 1:359 MEDICAL GROUP
Mailing Address - Street 2:221 THIRD STREET WEST
Mailing Address - City:JBSA-RANDOLPH
Mailing Address - State:TX
Mailing Address - Zip Code:78150
Mailing Address - Country:US
Mailing Address - Phone:210-808-5940
Mailing Address - Fax:
Practice Address - Street 1:359 MEDICAL GROUP
Practice Address - Street 2:221 THIRD STREET WEST
Practice Address - City:JBSA-RANDOLPH
Practice Address - State:TX
Practice Address - Zip Code:78150
Practice Address - Country:US
Practice Address - Phone:850-883-8314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist