Provider Demographics
NPI:1871814947
Name:QUICK, MICHAEL D (CPO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:QUICK
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 AINSWORTH DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1625
Mailing Address - Country:US
Mailing Address - Phone:928-776-0823
Mailing Address - Fax:
Practice Address - Street 1:808 AINSWORTH DR STE 101
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1625
Practice Address - Country:US
Practice Address - Phone:928-776-0823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist