Provider Demographics
NPI:1194453365
Name:OPTIMAL HEALTH CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:OPTIMAL HEALTH CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-243-0633
Mailing Address - Street 1:1260 S FRONTAGE RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033
Mailing Address - Country:US
Mailing Address - Phone:651-243-0633
Mailing Address - Fax:
Practice Address - Street 1:1260 S FRONTAGE RD.
Practice Address - Street 2:SUITE B
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033
Practice Address - Country:US
Practice Address - Phone:651-243-0633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty