Provider Demographics
NPI:1144835141
Name:QUINN, JOSEPH MORGAN (OTR/L)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MORGAN
Last Name:QUINN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3343 MEMORIAL BLVD APT G310
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5437
Mailing Address - Country:US
Mailing Address - Phone:901-218-5384
Mailing Address - Fax:
Practice Address - Street 1:2208 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5800
Practice Address - Country:US
Practice Address - Phone:615-809-2632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6649225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1234567789Medicaid