Provider Demographics
NPI:1629354832
Name:OPTIMUM CHIROPRACTIC PC
Entity Type:Organization
Organization Name:OPTIMUM CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:VOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-225-9200
Mailing Address - Street 1:7205 VISTA DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9360
Mailing Address - Country:US
Mailing Address - Phone:515-225-9200
Mailing Address - Fax:
Practice Address - Street 1:7205 VISTA DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-9360
Practice Address - Country:US
Practice Address - Phone:515-225-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty