Provider Demographics
NPI:1518730076
Name:QUALITY CARE CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:QUALITY CARE CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:THIEDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-785-5006
Mailing Address - Street 1:1034 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-1310
Mailing Address - Country:US
Mailing Address - Phone:715-785-5006
Mailing Address - Fax:
Practice Address - Street 1:1034 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-1310
Practice Address - Country:US
Practice Address - Phone:715-785-5006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty