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General NPI Number Information
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NPI Number | 1447326996
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Entity Type | Individual
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Provider Name | MARIE LOUISE QUIMSON P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 771 JACKSON ST SUITE B
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City | HAYWARD
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State | CA
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Zip | 94544-1032
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Country | US
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Telephone | 510-888-9300
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Fax | 510-280-8802
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Provider Business Mailing Address
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Address Line | PO BOX 1619
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City | UNION CITY
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State | CA
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Zip | 94587-6619
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Country | US
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Telephone | 510-888-9300
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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 | 28653
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License Number State | CA
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