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Organization

OPTIMUM HEALTH & REHAB LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL WILCZAK DC, MSR (ALTERNATIVE HEALTHCARE PRACTITIONER)
(575) 652-6433
Entity
Organization

Contact information

Practice address
221 N MAIN ST, LAS CRUCES, NM 88001-1274
(575) 652-6433
Mailing address
221 N MAIN ST, LAS CRUCES, NM 88001-1274
(575) 652-6433

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
171100000X
Acupuncturist
175F00000X
Naturopath
Primary
175L00000X
Homeopath
225100000X
Physical Therapist
225400000X
Rehabilitation Practitioner
225700000X
Massage Therapist
226300000X
Kinesiotherapist

Other

Enumeration date
09/28/2018
Last updated
09/28/2018
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