Provider Demographics
NPI:1376118752
Name:URRECHAGA QUICK, ANDREW LUIS (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:LUIS
Last Name:URRECHAGA QUICK
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 1:6297 OLD JACKSONBORO RD
Mailing Address - Street 2:
Mailing Address - City:RAVENEL
Mailing Address - State:SC
Mailing Address - Zip Code:29470-5288
Mailing Address - Country:US
Mailing Address - Phone:843-377-9554
Mailing Address - Fax:
Practice Address - Street 1:105 GREENLAND DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5354
Practice Address - Country:US
Practice Address - Phone:843-377-9554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor