Provider Demographics
NPI:1912641531
Name:HILL, QUINTEZ JUWAN (DC)
Entity Type:Individual
Prefix:
First Name:QUINTEZ
Middle Name:JUWAN
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MARYMEADE DR APT 805
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-5253
Mailing Address - Country:US
Mailing Address - Phone:864-367-5104
Mailing Address - Fax:
Practice Address - Street 1:607 W 5TH NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6166
Practice Address - Country:US
Practice Address - Phone:843-873-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor