Provider Demographics
NPI:1235270976
Name:QUINTAS, JAMES EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:QUINTAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8513 HOSPITAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-7509
Mailing Address - Country:US
Mailing Address - Phone:770-577-9213
Mailing Address - Fax:770-577-9214
Practice Address - Street 1:8513 HOSPITAL DR STE C
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-7509
Practice Address - Country:US
Practice Address - Phone:770-577-9213
Practice Address - Fax:770-577-9214
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU42176Medicare UPIN
GA35ZCDZCMedicare ID - Type Unspecified