Provider Demographics
NPI:1902032402
Name:QUITMAN HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:QUITMAN HEALTH SERVICES, PLLC
Other - Org Name:QUITMAN CHIROPRACTIC AND ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DEREK
Authorized Official - Last Name:WISDOM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-763-4404
Mailing Address - Street 1:1018 E. GOODE ST., SUITE 102
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783
Mailing Address - Country:US
Mailing Address - Phone:903-763-4404
Mailing Address - Fax:903-763-2550
Practice Address - Street 1:1018 E. GOODE ST., SUITE 102
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2563
Practice Address - Country:US
Practice Address - Phone:903-763-4404
Practice Address - Fax:903-763-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7361111N00000X
TX7360111NR0400X
225100000X
TX109347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty