Individual
CURTIS WRIGHT BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, ATC
Contact information
Practice address
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5925
(770) 237-3475
(770) 237-3756
Mailing address
1900 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5925
(770) 237-3475
(770) 237-3756
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT000825
GA
2255A2300X
Athletic Trainer
ATC000238
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00416901
RAILROAD MEDICARE
GA
Enumeration date
10/24/2006
Last updated
02/12/2008
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