Provider Demographics
NPI:1407451941
Name:OPTIMAL HEALTH AND WELLNESS INC
Entity Type:Organization
Organization Name:OPTIMAL HEALTH AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WENDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-902-1102
Mailing Address - Street 1:1657 WHITE CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8187
Mailing Address - Country:US
Mailing Address - Phone:517-902-1102
Mailing Address - Fax:
Practice Address - Street 1:1657 WHITE CLIFF DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8187
Practice Address - Country:US
Practice Address - Phone:517-902-1102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty