Provider Demographics
NPI:1114091063
Name:QUINN, PAUL G (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:QUINN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:WELLNESS
Other - Middle Name:
Other - Last Name:QUESTCHIROPRATIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1564 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1505
Mailing Address - Country:US
Mailing Address - Phone:610-640-9355
Mailing Address - Fax:610-640-0181
Practice Address - Street 1:970 PULASKI DR
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2802
Practice Address - Country:US
Practice Address - Phone:610-731-1123
Practice Address - Fax:215-551-3320
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 009420111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2409290000OtherINDEPENDENCE BC BS NO
PA092718Medicare ID - Type Unspecified