Healthcare Provider Details

I. General information

NPI: 1386690576
Provider Name (Legal Business Name): CHRISTOPHER M QUINN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: Q MED INC

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CASS AVE
WOONSOCKET RI
02895-4705
US

IV. Provider business mailing address

PO BOX 8879
CRANSTON RI
02920-0879
US

V. Phone/Fax

Practice location:
  • Phone: 401-769-4100
  • Fax:
Mailing address:
  • Phone: 401-572-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number81602
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: