Provider Demographics
NPI:1780841346
Name:HEALTH QUEST PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HEALTH QUEST PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:W
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-635-9655
Mailing Address - Street 1:3349 AMERICAN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109
Mailing Address - Country:US
Mailing Address - Phone:573-635-9655
Mailing Address - Fax:573-635-6741
Practice Address - Street 1:3349 AMERICAN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109
Practice Address - Country:US
Practice Address - Phone:573-635-9655
Practice Address - Fax:573-635-6741
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH QUEST PHYSICIANS GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy