Provider Demographics
NPI:1386879823
Name:BRIAN K. CURTIS
Entity type:Organization
Organization Name:BRIAN K. CURTIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-947-2805
Mailing Address - Street 1:625 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-1590
Mailing Address - Country:US
Mailing Address - Phone:740-947-2805
Mailing Address - Fax:740-947-2975
Practice Address - Street 1:625 E 5TH ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-1590
Practice Address - Country:US
Practice Address - Phone:740-947-2805
Practice Address - Fax:740-947-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200913400408332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals