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General NPI Number Information
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NPI Number | 1053246900
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Entity Type | Individual
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Provider Name | ANDY QUIJADA ATC
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Gender | Male
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 710 N TURNER AVE
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City | HASTINGS
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State | NE
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Zip | 68901-7621
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Country | US
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Telephone | 800-532-7642
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Fax |
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Provider Business Mailing Address
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Address Line | 706 E LINDEN ST
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City | ROGERS
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State | AR
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Zip | 72756-6019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | NE
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