Provider Demographics
NPI:1851425508
Name:HEALTH QUEST CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HEALTH QUEST CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCEP
Authorized Official - Phone:208-375-3500
Mailing Address - Street 1:1100 N COLE ROAD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704
Mailing Address - Country:US
Mailing Address - Phone:208-375-3500
Mailing Address - Fax:208-375-3716
Practice Address - Street 1:1100 N COLE ROAD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704
Practice Address - Country:US
Practice Address - Phone:208-375-3500
Practice Address - Fax:208-375-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDC1633OtherBLUE CROSS
C1633OtherBC
HI000010027794OtherBLUE SHIELD
IDC1633OtherBLUE CROSS
IDU79266Medicare UPIN
IDC1633OtherBLUE CROSS
16741641Medicare PIN