Provider Demographics
NPI:1548296007
Name:QUEST HEALTH SYSTEMS X PLLC
Entity type:Organization
Organization Name:QUEST HEALTH SYSTEMS X PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:COGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:2484-471-6963
Mailing Address - Street 1:36016 5 MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1918
Mailing Address - Country:US
Mailing Address - Phone:734-591-0404
Mailing Address - Fax:
Practice Address - Street 1:36016 5 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1918
Practice Address - Country:US
Practice Address - Phone:734-591-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N54450Medicare ID - Type Unspecified