Provider Demographics
NPI:1962988584
Name:CURTIS, MARY L
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:L
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 THOMASTON COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04861-3524
Mailing Address - Country:US
Mailing Address - Phone:207-596-1060
Mailing Address - Fax:
Practice Address - Street 1:55 THOMASTON COMMONS WAY
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:ME
Practice Address - Zip Code:04861-3524
Practice Address - Country:US
Practice Address - Phone:207-596-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist