Quantum Genesis Inc.

NPI Provider: 1285631416
Contact Name: Hicks L David
Position: Physician/CEO
Phone: (727) 787-3911

Quantum Genesis Inc. Information:

Quantum Genesis Inc. organization have npi 1285631416, taxonomy code is 207Q00000X with license number is OS4796 in . This Business address located in 3165 N McMullen Booth Rd, Clearwater, FL 33761 Florida.

Practice Location
Address: 3165 N McMullen Booth Rd, Clearwater, FL 33761
Phone: (727) 787-3911

Business Location
Address: 3165 N McMullen Booth Rd, Clearwater, FL 33761
Phone: (727) 787-3911
Fax: (727) 786-2226

Taxonomy

Taxonomy Code: 207Q00000X

License Number: OS4796

License Number of State: FL

Primary Taxonomy Switch: Y

Enumeration Date: 7/1/2005

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