Provider Demographics
NPI:1396800785
Name:QUINN, ERIC LAWRENCE (ATC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LAWRENCE
Last Name:QUINN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2796 SHARON ST
Mailing Address - Street 2:
Mailing Address - City:WEEDSPORT
Mailing Address - State:NY
Mailing Address - Zip Code:13166-9770
Mailing Address - Country:US
Mailing Address - Phone:315-730-6057
Mailing Address - Fax:
Practice Address - Street 1:8852 HORTON ST
Practice Address - Street 2:
Practice Address - City:WEEDSPORT
Practice Address - State:NY
Practice Address - Zip Code:13166-9647
Practice Address - Country:US
Practice Address - Phone:315-730-6057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0006902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer