Provider Demographics
NPI:1427704246
Name:OPTIMAL ORTHOPAEDICS PLLC
Entity type:Organization
Organization Name:OPTIMAL ORTHOPAEDICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CCEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-876-6180
Mailing Address - Street 1:3605 EDGMONT AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-2862
Mailing Address - Country:US
Mailing Address - Phone:610-876-6180
Mailing Address - Fax:610-876-6130
Practice Address - Street 1:6 SHARPLEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2941
Practice Address - Country:US
Practice Address - Phone:302-652-0411
Practice Address - Fax:302-652-1116
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1326655267
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain