Individual
MICHELLE QUIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 HAZARD AVE, SUITE B, ENFIELD, CT 06082-4521
(860) 265-2571
Mailing address
435 HARTFORD TPKE, SUITE U, VERNON, CT 06066-4852
(860) 979-1611
(203) 866-3014
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
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