Provider Demographics
NPI:1477562569
Name:BRIAN PETER QUINN
Entity Type:Organization
Organization Name:BRIAN PETER QUINN
Other - Org Name:LIVERMORE PHYSICAL THERAPY AND SPORTS REHABILITATION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:B.
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT ATC
Authorized Official - Phone:925-443-9030
Mailing Address - Street 1:1080 CONCANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6577
Mailing Address - Country:US
Mailing Address - Phone:925-443-9030
Mailing Address - Fax:
Practice Address - Street 1:1080 CONCANNON BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6577
Practice Address - Country:US
Practice Address - Phone:925-443-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2009-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy