Provider Demographics
NPI:1902978554
Name:HEALTHQUEST CHIROPRACTIC
Entity Type:Organization
Organization Name:HEALTHQUEST CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOWALCZUK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-864-2000
Mailing Address - Street 1:1528 BRICE ROAD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068
Mailing Address - Country:US
Mailing Address - Phone:614-864-2000
Mailing Address - Fax:614-864-9121
Practice Address - Street 1:1528 BRICE ROAD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-864-2000
Practice Address - Fax:614-864-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0728976Medicaid
OH6176030001Medicare NSC