Provider Demographics
NPI:1356894547
Name:WORKHEALTH-QUINCY, PLLC
Entity type:Organization
Organization Name:WORKHEALTH-QUINCY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT- MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:517-639-7300
Mailing Address - Street 1:181 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MI
Mailing Address - Zip Code:49082-1165
Mailing Address - Country:US
Mailing Address - Phone:517-639-7300
Mailing Address - Fax:517-639-7301
Practice Address - Street 1:181 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MI
Practice Address - Zip Code:49082-1165
Practice Address - Country:US
Practice Address - Phone:517-639-7300
Practice Address - Fax:517-639-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048149261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4897987Medicaid