Provider Demographics
NPI:1952544942
Name:MCQUISTON, TERESA (LMT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:MCQUISTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 ARGERIAN DR
Mailing Address - Street 2:STE 101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4140
Mailing Address - Country:US
Mailing Address - Phone:813-907-2774
Mailing Address - Fax:813-907-2723
Practice Address - Street 1:5801 ARGERIAN DR
Practice Address - Street 2:STE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4140
Practice Address - Country:US
Practice Address - Phone:813-907-2774
Practice Address - Fax:813-907-2723
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48812225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist