Provider Demographics
NPI:1083014617
Name:QUINLAN, JOSEPH (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:QUINLAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 SW VILLA WEST DR APT 2104
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-5414
Mailing Address - Country:US
Mailing Address - Phone:785-845-5481
Mailing Address - Fax:
Practice Address - Street 1:2745 SW VILLA WEST DR APT 2104
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5414
Practice Address - Country:US
Practice Address - Phone:785-845-5481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01776225200000X
KST-05045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant