Individual
MR. GREGORY STANFORD QUICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5301 DUVAL RD, AUSTIN, TX 78727-6618
(512) 335-1805
Mailing address
5301 DUVAL RD, AUSTIN, TX 78727-6618
(512) 335-1805
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
TX
Enumeration date
08/14/2018
Last updated
08/14/2018
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