Organization
OPTIMAL MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES KIPP HEACOCK MD (OWNER)
(732) 814-9807
Entity
Organization
Contact information
Practice address
1640 ROUTE 88, SUITE 203, BRICK, NJ 08724-3068
(732) 814-9807
Mailing address
1640 ROUTE 88, SUITE 203, BRICK, NJ 08724-3068
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
25MA03492800
NJ
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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