Individual
TESS LACIE CURNYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
52500 FIR RD, GRANGER, IN 46530-8579
(574) 271-0700
(574) 273-5648
Mailing address
52500 FIR RD, GRANGER, IN 46530-8579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PENDING
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
STATE LICENSE
IN
Enumeration date
05/22/2017
Last updated
01/12/2021
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