Healthcare Provider Details

I. General information

NPI: 1619177110
Provider Name (Legal Business Name): WELLNESS QUEST CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 PULASKI DR
KING OF PRUSSIA PA
19406-2802
US

IV. Provider business mailing address

970 PULASKI DR
KING OF PRUSSIA PA
19406-2802
US

V. Phone/Fax

Practice location:
  • Phone: 610-640-9355
  • Fax: 610-640-0181
Mailing address:
  • Phone: 610-640-9355
  • Fax: 610-640-0181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009420
License Number StatePA

VIII. Authorized Official

Name: DR. PAUL G QUINN
Title or Position: OWNER
Credential: DC
Phone: 610-640-9355