Provider Demographics
NPI:1164762761
Name:MEDQUEST HEALTH CENTER INCORPORATED
Entity Type:Organization
Organization Name:MEDQUEST HEALTH CENTER INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GEHRISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-529-5544
Mailing Address - Street 1:33 S LEXINGTON SPRINGMILL RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1325
Mailing Address - Country:US
Mailing Address - Phone:419-529-5544
Mailing Address - Fax:419-529-8525
Practice Address - Street 1:33 S LEXINGTON SPRINGMILL RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1325
Practice Address - Country:US
Practice Address - Phone:419-529-5544
Practice Address - Fax:419-529-8525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072595208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty