# OPTIMAL HEALTH AND WELLNESS CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568100923
- **Authorized official:** MRS. MACKINZIE LEE NP (NURSE PRACTITIONER)
- **Authorized official phone:** (601) 502-4245

## Contact information

- **Practice address:** 1700 UNIVERSITY BLVD STE 8, JACKSON, MS 39204-3907
- **Practice address phone:** (601) 502-4245
- **Mailing address:** 4985 SPRINGRIDGE RD, RAYMOND, MS 39154-9492
- **Mailing address phone:** (601) 502-4245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/25/2022
- **Last updated:** 05/25/2022