Provider Demographics
NPI:1457787616
Name:OPTIMAL MOTION CHIROPRACTIC
Entity type:Organization
Organization Name:OPTIMAL MOTION CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-896-1040
Mailing Address - Street 1:7800 E ORCHARD RD
Mailing Address - Street 2:STE 320
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2583
Mailing Address - Country:US
Mailing Address - Phone:303-771-2494
Mailing Address - Fax:303-953-0625
Practice Address - Street 1:7800 E ORCHARD RD
Practice Address - Street 2:STE 320
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2583
Practice Address - Country:US
Practice Address - Phone:303-771-2494
Practice Address - Fax:303-953-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty