Provider Demographics
NPI:1124814405
Name:QUILLEN, DANIEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:QUILLEN
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 SUNSET HILL LN
Mailing Address - Street 2:
Mailing Address - City:TROUTVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24175-7203
Mailing Address - Country:US
Mailing Address - Phone:540-589-2745
Mailing Address - Fax:
Practice Address - Street 1:5832 HARBOUR VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3875
Practice Address - Country:US
Practice Address - Phone:757-668-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist