| Optimal Wellness Llc | |
|
745 Olive Street Suite 109 Shreveport LA 71104 | |
| (318) 716-1200 | |
| (318) 562-3330 |
| Full Name | Optimal Wellness Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 745 Olive Street, Shreveport, Louisiana |
| Authorized Official Name and Position | Sreedevi Yerrapragada (OFFICER/MANAGER) |
| Authorized Official Contact | 3187161200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Wellness Llc 745 Olive Street Suite 109 Shreveport LA 71104 Ph: (318) 716-1200 | Optimal Wellness Llc 745 Olive Street Suite 109 Shreveport LA 71104 Ph: (318) 716-1200 |
| NPI Number | 1063916195 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 03/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063916195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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