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NPI Code Detail

MEDICARE: MINDY L QUAIL PT

MEDICARE: MINDY L QUAIL 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 TherapistP19478NC
2225100000XPhysical Therapist070014958IL
3225100000XPhysical Therapist11257SC

General Provider Information

NPI Number : 1790882892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINDY L QUAIL PT
Provider Business Mailing Address
First Line : PO BOX 412066
Second Line :
City : BOSTON
State : MA
Zip : 02241-2066
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1738 CELANESE RD STE 102
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-1731
Country : US
Telephone Number : 803-670-3067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 05/02/2024

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Directions to “ MINDY L QUAIL PT” Practice Location

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