Provider Demographics
NPI:1285067926
Name:QUAIL, KEVIN ANDREW (DPT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:ANDREW
Last Name:QUAIL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12143 CLARKSVILLE PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1565
Mailing Address - Country:US
Mailing Address - Phone:410-644-1880
Mailing Address - Fax:
Practice Address - Street 1:12143 CLARKSVILLE PIKE STE 101
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1565
Practice Address - Country:US
Practice Address - Phone:410-644-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist