Provider Demographics
NPI:1447806161
Name:OPTIMAL THERAPY INC
Entity Type:Organization
Organization Name:OPTIMAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:732-703-1453
Mailing Address - Street 1:2662 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2645
Mailing Address - Country:US
Mailing Address - Phone:732-703-1453
Mailing Address - Fax:
Practice Address - Street 1:115 S MAIN ST APT 10
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2846
Practice Address - Country:US
Practice Address - Phone:732-703-1453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT023347OtherCOMMONWEALTH OF PENNSYLVANIA DEPARTMENT