Provider Demographics
NPI:1366979122
Name:OPTIMAL HEALTH PLLC
Entity type:Organization
Organization Name:OPTIMAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-691-9055
Mailing Address - Street 1:217 N CALDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-2111
Mailing Address - Country:US
Mailing Address - Phone:865-983-8330
Mailing Address - Fax:865-862-8099
Practice Address - Street 1:8874 KINGSTON PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5010
Practice Address - Country:US
Practice Address - Phone:865-691-9055
Practice Address - Fax:865-531-9018
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMAL HEALTH PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-11
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty