Provider Demographics
NPI:1033594130
Name:OPTIMUS LLC
Entity Type:Organization
Organization Name:OPTIMUS LLC
Other - Org Name:OPTIMUS PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:937-454-1900
Mailing Address - Street 1:3132 OLENTANGY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1517
Mailing Address - Country:US
Mailing Address - Phone:614-263-5462
Mailing Address - Fax:614-263-6770
Practice Address - Street 1:3132 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1517
Practice Address - Country:US
Practice Address - Phone:614-263-5462
Practice Address - Fax:614-263-6770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.004254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty