Provider Demographics
NPI:1497299085
Name:QUANTUM HEALTH PRACTICE, LLC
Entity Type:Organization
Organization Name:QUANTUM HEALTH PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-931-1217
Mailing Address - Street 1:505 YORK RD
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2136
Mailing Address - Country:US
Mailing Address - Phone:267-626-2334
Mailing Address - Fax:
Practice Address - Street 1:505 YORK RD
Practice Address - Street 2:SUITE 7A
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2136
Practice Address - Country:US
Practice Address - Phone:267-626-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty