Provider Demographics
NPI:1427393651
Name:QUINN, CATHY EDWARDS (PT)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:EDWARDS
Last Name:QUINN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W MYSTIC CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4691
Mailing Address - Country:US
Mailing Address - Phone:801-652-7499
Mailing Address - Fax:
Practice Address - Street 1:709 W MYSTIC CREEK WAY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4691
Practice Address - Country:US
Practice Address - Phone:801-652-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4950189-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist