Provider Demographics
NPI:1548243454
Name:HEALTH QUEST PHYSICAL THERAPY & FITNESS CENTER, INC.
Entity Type:Organization
Organization Name:HEALTH QUEST PHYSICAL THERAPY & FITNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:ZWETSLOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-938-3344
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:WEED
Mailing Address - State:CA
Mailing Address - Zip Code:96094-0489
Mailing Address - Country:US
Mailing Address - Phone:530-938-3344
Mailing Address - Fax:530-938-3340
Practice Address - Street 1:161 E LINCOLN AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:WEED
Practice Address - State:CA
Practice Address - Zip Code:96094-9609
Practice Address - Country:US
Practice Address - Phone:530-938-3344
Practice Address - Fax:530-309-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 20201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31519ZMedicare ID - Type UnspecifiedGROUP NUMBER