Healthcare Provider Details

I. General information

NPI: 1073886347
Provider Name (Legal Business Name): ANGELA N QUICK DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 BUTTONWOOD DR
COLUMBIA MO
65201-3712
US

IV. Provider business mailing address

3307 BELINDA CT
COLUMBIA MO
65203-3847
US

V. Phone/Fax

Practice location:
  • Phone: 573-449-7387
  • Fax: 573-449-0858
Mailing address:
  • Phone: 314-210-3589
  • Fax: 573-449-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number2007014077
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: