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General NPI Number Information
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NPI Number | 1750652863
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Entity Type | Organization
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Legal Business Name | IN-QUEST MEDICAL RESEARCH, LLC
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 6330 PRIMROSE HILL CT SUITE 208
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City | NORCROSS
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State | GA
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Zip | 30092-4544
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Country | US
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Telephone | 770-903-0148
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Fax | 770-903-0175
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Provider Business Mailing Address
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Address Line | 6330 PRIMROSE HILL CT SUITE 208
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City | NORCROSS
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State | GA
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Zip | 30092-4544
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Country | US
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Telephone | 770-903-0148
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Fax | 770-903-0175
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA MARIE CRANDALL
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Credential | APRN FNP-BC
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Telephone | 770-903-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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