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Organization

QUEST PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EVAN ERICKSON (OWNER/PARTNER)
(937) 342-9861
Entity
Organization

Contact information

Practice address
1176 E HOME RD, SPRINGFIELD, OH 45503-2726
(937) 342-9861
(937) 390-7146
Mailing address
1176 E HOME RD, SPRINGFIELD, OH 45503-2726
(937) 342-9861
(937) 390-7146

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0135772
OH
Enumeration date
03/16/2015
Last updated
03/03/2016
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