Provider Demographics
NPI:1760673388
Name:HEALTHQUEST CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:HEALTHQUEST CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:CADOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-995-0990
Mailing Address - Street 1:1832 OAK HOLLOW DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5902
Mailing Address - Country:US
Mailing Address - Phone:231-995-0990
Mailing Address - Fax:231-995-0991
Practice Address - Street 1:1832 OAK HOLLOW DR
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5902
Practice Address - Country:US
Practice Address - Phone:231-995-0990
Practice Address - Fax:231-995-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU87587Medicare UPIN