Provider Demographics
NPI:1841479508
Name:OPTIMAL HEALTH CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:OPTIMAL HEALTH CHIROPRACTIC CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-964-9966
Mailing Address - Street 1:802 SE ORALABOR RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4009
Mailing Address - Country:US
Mailing Address - Phone:515-964-9966
Mailing Address - Fax:515-964-2012
Practice Address - Street 1:802 SE ORALABOR RD
Practice Address - Street 2:SUITE 121
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-4009
Practice Address - Country:US
Practice Address - Phone:515-964-9966
Practice Address - Fax:515-964-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty