Provider Demographics
NPI:1871018044
Name:QUINN, MARSHA L (PT, TDPT)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:L
Last Name:QUINN
Suffix:
Gender:F
Credentials:PT, TDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3992 TANGLE DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2261
Mailing Address - Country:US
Mailing Address - Phone:321-543-5489
Mailing Address - Fax:
Practice Address - Street 1:3992 TANGLE DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2261
Practice Address - Country:US
Practice Address - Phone:321-543-5489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL54342251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology