Individual
MRS. HAILEY BETH QUICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
506 HOLLY AVE, LOGAN, WV 25601-3306
(304) 752-1550
Mailing address
128 SAYER CIR, LOGAN, WV 25601-3054
(304) 752-1037
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1556
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060164000
—
WV
Enumeration date
06/10/2008
Last updated
01/05/2012
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