Healthcare Provider Details

I. General information

NPI: 1891725073
Provider Name (Legal Business Name): RICHARD I QUINCY JR. MS, PT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 CURTIS ST
DENVER CO
80205-2633
US

IV. Provider business mailing address

757 E. 20TH AVE., STE 370
DENVER CO
80205-3652
US

V. Phone/Fax

Practice location:
  • Phone: 305-433-0284
  • Fax:
Mailing address:
  • Phone: 305-433-0284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT015049
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT004538
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number0003770
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: