Individual
MICHELLE QUIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
005596
CT
225100000X
Physical Therapist
Primary
005596
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004167278
—
CT
01
—
080005596CT27
BCBS
CT
Enumeration date
06/09/2006
Last updated
01/28/2016
Update your record
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