Provider Demographics
NPI:1174263305
Name:QUAY, SETH ROBERT (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:ROBERT
Last Name:QUAY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 HONEYWOOD LN APT H
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8850
Mailing Address - Country:US
Mailing Address - Phone:740-777-8769
Mailing Address - Fax:
Practice Address - Street 1:300 PELL AVE STE B
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1182
Practice Address - Country:US
Practice Address - Phone:540-484-1456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist