Provider Demographics
NPI:1376439018
Name:POORMAN, CURTIS J
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:J
Last Name:POORMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 E 5550 S STE 23
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4308
Mailing Address - Country:US
Mailing Address - Phone:801-475-4673
Mailing Address - Fax:
Practice Address - Street 1:1708 E 5550 S STE 23
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4308
Practice Address - Country:US
Practice Address - Phone:801-475-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTF25-117843175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist