Healthcare Provider Details

I. General information

NPI: 1811828494
Provider Name (Legal Business Name): ASHLEY JEAN QUINN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 E SHERMAN BLVD
NORTON SHORES MI
49444-1805
US

IV. Provider business mailing address

1953 E GARFIELD RD
HESPERIA MI
49421-9596
US

V. Phone/Fax

Practice location:
  • Phone: 231-737-4374
  • Fax:
Mailing address:
  • Phone: 231-660-3675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502009054
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: