Provider Demographics
NPI:1073844023
Name:QUENZER, DAVID CARL (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARL
Last Name:QUENZER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:CARL
Other - Last Name:QUENZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 721279
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73172-1279
Mailing Address - Country:US
Mailing Address - Phone:405-474-9111
Mailing Address - Fax:405-728-8781
Practice Address - Street 1:12209 SYLVESTER DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1067
Practice Address - Country:US
Practice Address - Phone:405-474-9111
Practice Address - Fax:405-728-8781
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3019111N00000X
OK103838163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No111N00000XChiropractic ProvidersChiropractor