Provider Demographics
NPI:1043592660
Name:DOWELL, QUINTUS AVERY
Entity Type:Individual
Prefix:
First Name:QUINTUS
Middle Name:AVERY
Last Name:DOWELL
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 1:27440 KALISH CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4111
Mailing Address - Country:US
Mailing Address - Phone:248-476-2592
Mailing Address - Fax:248-476-2592
Practice Address - Street 1:28275 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 111
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3766
Practice Address - Country:US
Practice Address - Phone:248-476-2592
Practice Address - Fax:248-476-2592
Is Sole Proprietor?:No
Enumeration Date:2011-09-10
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist