Provider Demographics
NPI:1821153875
Name:QUAN, TERRY (DC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:QUAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W INDIANTOWN RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7525
Mailing Address - Country:US
Mailing Address - Phone:561-748-2273
Mailing Address - Fax:561-748-4856
Practice Address - Street 1:601 W INDIANTOWN RD
Practice Address - Street 2:SUITE #2
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7525
Practice Address - Country:US
Practice Address - Phone:561-748-2273
Practice Address - Fax:561-748-4856
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor