Provider Demographics
NPI:1568594836
Name:QUINN, CAROL W (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:W
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 1:573 BLUESTEM DR. UNIT 77A
Mailing Address - Street 2:
Mailing Address - City:PAWLEY'S ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585
Mailing Address - Country:US
Mailing Address - Phone:843-979-0824
Mailing Address - Fax:
Practice Address - Street 1:573 BLUE STEM DR UNIT 77A
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-8315
Practice Address - Country:US
Practice Address - Phone:843-979-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4829225100000X
CT1008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist