Basic Information
Provider Information
NPI: 1477128759
EntityType: 2
ReplacementNPI:  
OrganizationName: QUEST HEALTH & REHAB LLC
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Mailing Information
Address1: PO BOX 5718
Address2:  
City: KALISPELL
State: MT
PostalCode: 599035718
CountryCode: US
TelephoneNumber: 4067560134
FaxNumber: 4063001612
Practice Location
Address1: 4216 WASHINGTON RD STE 2
Address2:  
City: EVANS
State: GA
PostalCode: 308094717
CountryCode: US
TelephoneNumber: 7068145460
FaxNumber: 7068145574
Other Information
ProviderEnumerationDate: 05/20/2021
LastUpdateDate: 05/20/2021
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AuthorizedOfficialLastName: STIMAC
AuthorizedOfficialFirstName: BLAINE
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AuthorizedOfficialTitleorPosition: MANAGING MEMBER
AuthorizedOfficialTelephone: 4067561128
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MSPT
NPICertificationDate: 05/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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