Provider Demographics
NPI:1982425484
Name:HAISLOP, QUINNTON PRICE (DC)
Entity type:Individual
Prefix:
First Name:QUINNTON
Middle Name:PRICE
Last Name:HAISLOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 WELSFORD CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-8702
Mailing Address - Country:US
Mailing Address - Phone:740-577-1412
Mailing Address - Fax:
Practice Address - Street 1:1504 YANKEE PARK PL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1878
Practice Address - Country:US
Practice Address - Phone:937-424-3068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty