Provider Demographics
NPI:1679980981
Name:QUIGLEY, ADAM GREGORY (ATC, SCAT)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:GREGORY
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:ATC, SCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 SOUTHERN DR
Mailing Address - Street 2:#2503
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5189
Mailing Address - Country:US
Mailing Address - Phone:301-996-6804
Mailing Address - Fax:803-509-6390
Practice Address - Street 1:1051 SOUTHERN DR
Practice Address - Street 2:#2503
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5189
Practice Address - Country:US
Practice Address - Phone:301-996-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2015-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer