Provider Demographics
NPI:1457477119
Name:QUINONES, JULIO EMILIO (RPT)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:EMILIO
Last Name:QUINONES
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GAS LIGHT DR APT 4
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2232
Mailing Address - Country:US
Mailing Address - Phone:781-974-5678
Mailing Address - Fax:
Practice Address - Street 1:125 BROAD ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-2336
Practice Address - Country:US
Practice Address - Phone:781-337-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17232225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist