Provider Demographics
NPI:1841667961
Name:CURTIS, KALEB RAY (LPNA, ATC)
Entity type:Individual
Prefix:MR
First Name:KALEB
Middle Name:RAY
Last Name:CURTIS
Suffix:
Gender:M
Credentials:LPNA, ATC
Other - Prefix:
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Mailing Address - Street 1:202 STROTHER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1258
Mailing Address - Country:US
Mailing Address - Phone:859-398-8547
Mailing Address - Fax:859-497-0883
Practice Address - Street 1:189 OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-5544
Practice Address - Country:US
Practice Address - Phone:502-379-8870
Practice Address - Fax:502-394-3600
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY20000223982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer