Provider Demographics
NPI:1225390172
Name:QUINAN, TARA BETH (RMT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:BETH
Last Name:QUINAN
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 US HIGHWAY 287
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7080
Mailing Address - Country:US
Mailing Address - Phone:303-469-0353
Mailing Address - Fax:303-469-1066
Practice Address - Street 1:1140 US HIGHWAY 287
Practice Address - Street 2:SUITE 100
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7080
Practice Address - Country:US
Practice Address - Phone:303-469-0353
Practice Address - Fax:303-469-1066
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4204174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist