Provider Demographics
NPI:1265470926
Name:OPTIMAL HEALTH CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:OPTIMAL HEALTH CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOANMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEALS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-521-5215
Mailing Address - Street 1:10255 INDUSTRIAL BLVD NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-6323
Mailing Address - Country:US
Mailing Address - Phone:678-418-3400
Mailing Address - Fax:678-418-3444
Practice Address - Street 1:10255 INDUSTRIAL BLVD NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-6323
Practice Address - Country:US
Practice Address - Phone:678-418-3400
Practice Address - Fax:678-418-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7129111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty