Healthcare Provider Details

I. General information

NPI: 1114091063
Provider Name (Legal Business Name): PAUL G. QUINN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WELLNESS QUESTCHIROPRATIC D.C.

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 PULASKI DR
KING OF PRUSSIA PA
19406-2802
US

IV. Provider business mailing address

1564 E LANCASTER AVE
PAOLI PA
19301-1505
US

V. Phone/Fax

Practice location:
  • Phone: 610-731-1123
  • Fax: 215-551-3320
Mailing address:
  • Phone: 610-640-9355
  • Fax: 610-640-0181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC 009420
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: