Provider Demographics
NPI:1871779660
Name:HEALTHQUEST CHIROPRACTIC
Entity type:Organization
Organization Name:HEALTHQUEST CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-778-5123
Mailing Address - Street 1:383 WILTON RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6124
Mailing Address - Country:US
Mailing Address - Phone:207-778-5123
Mailing Address - Fax:207-778-5125
Practice Address - Street 1:383 WILTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6124
Practice Address - Country:US
Practice Address - Phone:207-778-5123
Practice Address - Fax:207-778-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0006607Medicare PIN