Provider Demographics
NPI:1932631272
Name:QUOI, SAMUEL S
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:S
Last Name:QUOI
Suffix:
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 1:5225 E CHARLESTON BLVD APT 2031
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-1026
Mailing Address - Country:US
Mailing Address - Phone:978-429-7277
Mailing Address - Fax:
Practice Address - Street 1:5225 E CHARLESTON BLVD APT 2031
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-1026
Practice Address - Country:US
Practice Address - Phone:978-429-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner