Provider Demographics
NPI:1124081039
Name:QUICK, TED EUGENE (AT,C, CSCS)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:EUGENE
Last Name:QUICK
Suffix:
Gender:M
Credentials:AT,C, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6979 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-9617
Mailing Address - Country:US
Mailing Address - Phone:616-340-3786
Mailing Address - Fax:
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-780-4820
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer