Provider Demographics
NPI:1326178732
Name:MERKX-QUINN, MARIE LOUISE (PT, OCS, CERT MDT)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:LOUISE
Last Name:MERKX-QUINN
Suffix:
Gender:F
Credentials:PT, OCS, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 RAYBROOK ST SE
Mailing Address - Street 2:SUITE #304
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7717
Mailing Address - Country:US
Mailing Address - Phone:616-464-3580
Mailing Address - Fax:616-464-3581
Practice Address - Street 1:2020 RAYBROOK ST SE
Practice Address - Street 2:SUITE #304
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7717
Practice Address - Country:US
Practice Address - Phone:616-464-3580
Practice Address - Fax:616-464-3581
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL736622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D15723OtherBLUE CARE NETWORK
MI650D157230OtherBCBS OF MI
MI0D15723OtherBLUE CARE NETWORK