Provider Demographics
NPI:1205031291
Name:QUANTUM HEALTHWORK, INC
Entity Type:Organization
Organization Name:QUANTUM HEALTHWORK, INC
Other - Org Name:THE GENESIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-947-4454
Mailing Address - Street 1:104 COLONY PARK DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2792
Mailing Address - Country:US
Mailing Address - Phone:678-947-4454
Mailing Address - Fax:678-208-9876
Practice Address - Street 1:104 COLONY PARK DR
Practice Address - Street 2:SUITE 800
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2792
Practice Address - Country:US
Practice Address - Phone:678-947-4454
Practice Address - Fax:678-208-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012495207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty