Provider Demographics
NPI:1275651176
Name:HEALTH QUEST CHIROPRACTIC & PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:HEALTH QUEST CHIROPRACTIC & PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SINGLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ETTLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-356-9939
Mailing Address - Street 1:7920 MCDONOGH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5249
Mailing Address - Country:US
Mailing Address - Phone:410-356-9939
Mailing Address - Fax:410-356-9987
Practice Address - Street 1:7920 MCDONOGH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5249
Practice Address - Country:US
Practice Address - Phone:410-356-9939
Practice Address - Fax:410-356-9987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111N00000X
MD01788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty