Provider Demographics
NPI:1801840319
Name:OPTIMAL HEALTH CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:OPTIMAL HEALTH CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-482-7227
Mailing Address - Street 1:4284 TRAIL BOSS DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7512
Mailing Address - Country:US
Mailing Address - Phone:303-688-0454
Mailing Address - Fax:303-688-9998
Practice Address - Street 1:4284 TRAIL BOSS DR
Practice Address - Street 2:SUITE 120
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7512
Practice Address - Country:US
Practice Address - Phone:303-688-0454
Practice Address - Fax:303-688-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty