Provider Demographics
NPI:1447343348
Name:GREGORY, CURTIS GLENN (RPT)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:GLENN
Last Name:GREGORY
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:116 HICKORY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342-2302
Mailing Address - Country:US
Mailing Address - Phone:870-338-8844
Mailing Address - Fax:870-338-8108
Practice Address - Street 1:116 HICKORY HILLS DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-2302
Practice Address - Country:US
Practice Address - Phone:870-338-8844
Practice Address - Fax:870-338-8108
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W271Medicare ID - Type Unspecified