Healthcare Provider Details

I. General information

NPI: 1528896479
Provider Name (Legal Business Name): QUANTUM HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 VONS WAY DRIVE
PROVIDENCE UT
84332
US

IV. Provider business mailing address

1000 E BLUFF VIEW DR UNIT 80
WASHINGTON UT
84780-8908
US

V. Phone/Fax

Practice location:
  • Phone: 435-770-2828
  • Fax:
Mailing address:
  • Phone: 773-766-7081
  • Fax: 331-336-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CROSBIE
Title or Position: MD/CO-OWNER
Credential:
Phone: 435-770-2828