Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 1686-39 | WI |
Y | 213ES0000X | Sports Medicine | 1686-39 | WI |
NPI | 1326401407 |
---|---|
Provider Name | Kelsey Quinnell |
First Address | Barneveld, WI 53507-9589 |
Second Address | Stevens Point, WI 54482-8410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2016 |
Last Update Date | 09/11/2020 |