Healthcare Provider Details

I. General information

NPI: 1780185124
Provider Name (Legal Business Name): QUANTUM HEALING THERAPIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 N STATE ST STE 210
WESTERVILLE OH
43082-7135
US

IV. Provider business mailing address

8520 OLENCREST DR
LEWIS CENTER OH
43035-8870
US

V. Phone/Fax

Practice location:
  • Phone: 516-429-1231
  • Fax:
Mailing address:
  • Phone: 516-429-1231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000321
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.021310
License Number StateOH

VIII. Authorized Official

Name: JANINE MANSELL
Title or Position: OWNER
Credential: L.AC, L.M.T
Phone: 516-429-1231