Doctor Name: | JENNIFER LYNNE QUINLAN |
NPI Number: | 1114241635 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5101018891 |
Business Practice Address: | 26657 Woodward Ave Huntington Woods, MI - 480701371 |
Business Phone Number: | 2483988400 |
Business Fax Number: | 2483988487 |
Mailing Address: | 26657 Woodward Ave Ste 200, HUNTINGTON WOODS |
State: | MI |
Postal Code: | 480701304 |
Phone Number: | 2483988400 |
Fax Number: | |
NPI Enumeration Date: | 03/26/2010 |
NPI Last Update Date: | 01/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 5101018891 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |