Individual
RILEY QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 649-7900
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(146) 497-9004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2523
NE
363A00000X
Physician Assistant
Primary
5161-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100190376
—
WI
Enumeration date
08/22/2020
Last updated
06/26/2023
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