Healthcare Provider Details

I. General information

NPI: 1669644746
Provider Name (Legal Business Name): QUICK DEVELOPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2008
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 PARKWAY
VIENNA MO
65582
US

IV. Provider business mailing address

1015 SPRINGFIELD RD
OWENSVILLE MO
65066
US

V. Phone/Fax

Practice location:
  • Phone: 573-422-3230
  • Fax: 573-422-9999
Mailing address:
  • Phone: 573-437-2103
  • Fax: 573-437-2219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number031884
License Number StateMO

VIII. Authorized Official

Name: NANCY L QUICK
Title or Position: SECRETARY
Credential:
Phone: 573-437-2103