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General NPI Number Information
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NPI Number | 1134168404
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Entity Type | Individual
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Provider Name | JOSEPH URBAN QUADE P.T.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 1204 CLOQUET AVE
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City | CLOQUET
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State | MN
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Zip | 55720-1622
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Country | US
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Telephone | 218-878-0805
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Fax | 218-878-0794
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Provider Business Mailing Address
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Address Line | 507 N BLACKMAN AVE
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City | DULUTH
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State | MN
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Zip | 55811-5239
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Country | US
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Telephone | 218-341-1205
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6080
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License Number State | MN
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