Provider Demographics
NPI:1467704478
Name:MCQUARRIE, PENELOPE A (PT)
Entity Type:Individual
Prefix:MRS
First Name:PENELOPE
Middle Name:A
Last Name:MCQUARRIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:PENNY
Other - Middle Name:A
Other - Last Name:ZIEGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9722 MOUNT TABOR RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21769-9523
Mailing Address - Country:US
Mailing Address - Phone:240-818-8630
Mailing Address - Fax:240-356-0340
Practice Address - Street 1:4707 SCHLEY AVE # F
Practice Address - Street 2:STE 595
Practice Address - City:BRADDOCK HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21714-7500
Practice Address - Country:US
Practice Address - Phone:240-356-0330
Practice Address - Fax:240-356-0340
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist