Provider Demographics
NPI:1629109962
Name:QUEST PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:QUEST PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:GISELA
Authorized Official - Last Name:DURCHHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS
Authorized Official - Phone:513-774-7900
Mailing Address - Street 1:1232 NEALE LN
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-9493
Mailing Address - Country:US
Mailing Address - Phone:513-774-7900
Mailing Address - Fax:513-774-7999
Practice Address - Street 1:732 MIDDLETON WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-6989
Practice Address - Country:US
Practice Address - Phone:513-774-7900
Practice Address - Fax:513-774-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 005243261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2946076Medicaid
OHQU9369001Medicare PIN