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NPI Code Detail

MEDICARE: MISS QUINN KATHRYN MCCOY PT

MEDICARE: MISS QUINN KATHRYN MCCOY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2036PTMT
2225100000XPhysical Therapist1794SD

General Provider Information

NPI Number : 1093852220
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS QUINN KATHRYN MCCOY PT
Provider Business Mailing Address
First Line : 1136 PAISLEY TER
Second Line :
City : STURGIS
State : SD
Zip : 57785-2008
Country : US
Telephone Number : 719-510-8668
Fax Number :
Provider Business Practice Location Address
First Line : 1635 CAREGIVER CIR
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-8529
Country : US
Telephone Number : 605-755-1100
Fax Number : 605-755-1116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 05/10/2019

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