Provider Demographics
NPI:1750452538
Name:QUINN, DAVID PATRICK (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PATRICK
Last Name:QUINN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 BRIELLA DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3770
Mailing Address - Country:US
Mailing Address - Phone:561-345-1967
Mailing Address - Fax:
Practice Address - Street 1:7362 BRIELLA DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3770
Practice Address - Country:US
Practice Address - Phone:561-345-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31116225100000X
NH6181200111N00000X
NH3673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U41827Medicare UPIN
NHRE8559Medicare ID - Type Unspecified