Provider Demographics
NPI:1649464124
Name:QUINTON, EVERETTE BRONZE (ABOC)
Entity type:Individual
Prefix:MR
First Name:EVERETTE
Middle Name:BRONZE
Last Name:QUINTON
Suffix:
Gender:M
Credentials:ABOC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1568 N FARWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2366
Mailing Address - Country:US
Mailing Address - Phone:414-221-7055
Mailing Address - Fax:414-221-7056
Practice Address - Street 1:1568 N FARWELL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2366
Practice Address - Country:US
Practice Address - Phone:414-221-7055
Practice Address - Fax:414-221-7056
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician