# SISKIYOU PEDIATRIC THERAPIES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144996752
- **Authorized official:** DANIEL QUINN PT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (970) 948-0244

## Contact information

- **Practice address:** 665 A ST, ASHLAND, OR 97520-2070
- **Practice address phone:** (970) 948-0244
- **Practice address fax:** (503) 820-2690
- **Mailing address:** 665 A ST, ASHLAND, OR 97520-2070
- **Mailing address phone:** (970) 948-0244
- **Mailing address fax:** (503) 820-2690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | — | Yes |
| 225XP0200X | Pediatric Occupational Therapist | — | NULL | — |
| 225XP0200X | Pediatric Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 08/23/2021
- **Last updated:** 08/23/2021