Provider Demographics
NPI:1598797995
Name:HEALTHQUEST CHIROPRACTIC AND REHABILITATION
Entity Type:Organization
Organization Name:HEALTHQUEST CHIROPRACTIC AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCEP, CSCS
Authorized Official - Phone:715-369-4000
Mailing Address - Street 1:1818 N STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-2129
Mailing Address - Country:US
Mailing Address - Phone:715-369-4000
Mailing Address - Fax:
Practice Address - Street 1:1818 N STEVENS ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-2129
Practice Address - Country:US
Practice Address - Phone:715-369-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3824012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38937300Medicaid
WI38937300Medicaid