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General NPI Number Information
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NPI Number | 1194269951
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Entity Type | Individual
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Provider Name | QUENTIN RICE LMT, PHTC
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Gender | Male
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 1918 W FABYAN PKWY
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City | BATAVIA
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State | IL
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Zip | 60510-1215
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Country | US
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Telephone | 630-482-2485
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Fax | 630-482-2531
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Provider Business Mailing Address
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Address Line | 590 PERSIMMON ST
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City | DEKALB
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State | IL
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Zip | 60115-5938
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Country | US
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Telephone | 614-701-7317
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 022342
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 049.263898
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License Number State | IL
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