Organization
OPTIMA HEALTH & VITALITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE A RUNKEL (OFFICE MANAGER)
(715) 832-1953
Entity
Organization
Contact information
Practice address
3321 GOLF RD STE A, EAU CLAIRE, WI 54701-9190
(715) 832-1953
Mailing address
3321 GOLF RD STE A, EAU CLAIRE, WI 54701-9190
(715) 832-1953
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1708
—
111N00000X
Chiropractor
2844-012
WI
111N00000X
Chiropractor
3389
—
111N00000X
Chiropractor
4243
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB3736
PALMETTO
—
Enumeration date
07/23/2007
Last updated
06/10/2008
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