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General NPI Number Information
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NPI Number | 1942490750
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Entity Type | Organization
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Legal Business Name | LIFE QUEST CHIROPRACTIC CENTER BEMIDJI PC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 519 ANNE ST NW STE C
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City | BEMIDJI
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State | MN
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Zip | 56601-4279
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Country | US
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Telephone | 218-444-5700
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Fax | 218-444-5704
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Provider Business Mailing Address
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Address Line | PO BOX 1854 519 ANNE ST NW SUITE C
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City | BEMIDJI
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State | MN
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Zip | 56619-1854
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Country | US
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Telephone | 218-444-5700
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Fax | 218-444-5704
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Authorized Official
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Title or Position | OWNER/CLINIC DIRECTOR
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Name | DAVID C WOLD
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Credential | DC
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Telephone | 218-444-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4462
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License Number State | MN
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