Provider Demographics
NPI:1356087225
Name:OPTIMAL HEALTH PLLC
Entity Type:Organization
Organization Name:OPTIMAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-691-9055
Mailing Address - Street 1:8874 KINGSTON PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5025
Mailing Address - Country:US
Mailing Address - Phone:865-691-9055
Mailing Address - Fax:865-531-9018
Practice Address - Street 1:11660 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2659
Practice Address - Country:US
Practice Address - Phone:865-288-4200
Practice Address - Fax:865-531-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty