Provider Demographics
NPI:1891725073
Name:QUINCY, RICHARD I JR (MS, PT, ATC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:I
Last Name:QUINCY
Suffix:JR
Gender:M
Credentials:MS, PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 E. 20TH AVE., STE 370
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3652
Mailing Address - Country:US
Mailing Address - Phone:305-433-0284
Mailing Address - Fax:
Practice Address - Street 1:2615 CURTIS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2633
Practice Address - Country:US
Practice Address - Phone:305-433-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0150492251S0007X
OHAT0045382255A2300X
CO00037702251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO22Medicare UPIN
CO22Medicare ID - Type Unspecified