# OPTIMUM HEALTH OF WOODTOCK PC

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

## Provider details

- **NPI number:** 1881863454
- **Authorized official:** JOHN P LANIER MD (OWNER)
- **Authorized official phone:** (678) 546-0550

## Contact information

- **Practice address:** 8811 HIGHWAY 92, WOODSTOCK, GA 30189-6508
- **Practice address phone:** (770) 516-7477
- **Practice address fax:** (770) 516-7493
- **Mailing address:** 2855 HIGHWAY 317 STE 760L-318, SUWANEE, GA 30024-3563
- **Mailing address phone:** (678) 546-0550
- **Mailing address fax:** (678) 730-4378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | — |
| 111NR0400X | Rehabilitation Chiropractor | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |

## Other

- **Enumeration date:** 02/27/2008
- **Last updated:** 02/27/2008