Provider Demographics
NPI:1215440987
Name:QUIGLEY, JOSHUA MICHAEL (PTA)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SCHOLL DR
Mailing Address - Street 2:
Mailing Address - City:OLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19547-8848
Mailing Address - Country:US
Mailing Address - Phone:484-560-8640
Mailing Address - Fax:
Practice Address - Street 1:1 S HOME AVE
Practice Address - Street 2:
Practice Address - City:TOPTON
Practice Address - State:PA
Practice Address - Zip Code:19562-1317
Practice Address - Country:US
Practice Address - Phone:610-682-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE011597225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant