Provider Demographics
NPI:1063686541
Name:VISION QUEST CHIROPRACTIC & WELLNESS INC
Entity Type:Organization
Organization Name:VISION QUEST CHIROPRACTIC & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-269-0261
Mailing Address - Street 1:1101 SUPERMALL WAY
Mailing Address - Street 2:SUITE 1269
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-6511
Mailing Address - Country:US
Mailing Address - Phone:253-269-0261
Mailing Address - Fax:
Practice Address - Street 1:1101 SUPERMALL WAY
Practice Address - Street 2:SUITE #1269
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-6511
Practice Address - Country:US
Practice Address - Phone:253-269-0261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty