Provider Demographics
NPI:1609932656
Name:QUINT, JAN MARIE (DC)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:MARIE
Last Name:QUINT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 HUNTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632
Mailing Address - Country:US
Mailing Address - Phone:479-253-7105
Mailing Address - Fax:479-253-7086
Practice Address - Street 1:174 HUNTSVILLE RD
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632
Practice Address - Country:US
Practice Address - Phone:479-253-7105
Practice Address - Fax:479-253-7086
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2008-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59005OtherBLUE CROSS BLUE SHIELD
AR5C753Medicare PIN