Provider Demographics
NPI:1164987665
Name:QUINN, KRISTEN L (PTA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:QUINN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2389 AMESBURY RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4561
Mailing Address - Country:US
Mailing Address - Phone:330-760-2587
Mailing Address - Fax:
Practice Address - Street 1:528 ROTHROCK RD
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-3132
Practice Address - Country:US
Practice Address - Phone:844-488-8475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA011351225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant