Provider Demographics
NPI:1801080924
Name:OPTIMUM HEALTH CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:OPTIMUM HEALTH CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:NICOL
Authorized Official - Last Name:HUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-461-0366
Mailing Address - Street 1:4036 CENTER ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-5698
Mailing Address - Country:US
Mailing Address - Phone:330-460-5151
Mailing Address - Fax:866-843-1345
Practice Address - Street 1:4036 CENTER ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-5698
Practice Address - Country:US
Practice Address - Phone:330-460-5151
Practice Address - Fax:866-843-1345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty