Individual
LORI QUINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
48 SALEM DR, VERO BEACH, FL 32966-8788
(772) 563-3616
Mailing address
48 SALEM DR, VERO BEACH, FL 32966-8788
(772) 563-3616
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q500521619590
DRIVERS LICENSE
FL
Enumeration date
09/03/2021
Last updated
09/03/2021
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