Provider Demographics
NPI:1750764049
Name:QUASIUS, ROBERT THOMAS SR
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:THOMAS
Last Name:QUASIUS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S 5TH ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1240
Mailing Address - Country:US
Mailing Address - Phone:507-401-2298
Mailing Address - Fax:507-316-0312
Practice Address - Street 1:109 S 5TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1240
Practice Address - Country:US
Practice Address - Phone:507-401-0694
Practice Address - Fax:507-316-0312
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMARSHALL344600000X
171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No344600000XTransportation ServicesTaxi