Healthcare Provider Details

I. General information

NPI: 1740103449
Provider Name (Legal Business Name): KYLE JAMES QUINNTEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 COUNTY HIGHWAY I
CHIPPEWA FALLS WI
54729-2652
US

IV. Provider business mailing address

305 COLEMAN ST
CHIPPEWA FALLS WI
54729-2203
US

V. Phone/Fax

Practice location:
  • Phone: 720-588-2268
  • Fax:
Mailing address:
  • Phone: 715-523-2655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number13143-146
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: