| Optimal Health And Wellness, Llc | |
|
3601 W 133rd St Leawood KS 66209-3345 | |
| (913) 787-3728 | |
| (913) 730-5463 |
| Full Name | Optimal Health And Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3601 W 133rd St, Leawood, Kansas |
| Authorized Official Name and Position | Amanda Woodworth (MANAGING MEMBER) |
| Authorized Official Contact | 9137873728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Health And Wellness, Llc 3601 W 133rd St Leawood KS 66209 Ph: (913) 787-3728 | Optimal Health And Wellness, Llc 3601 W 133rd St Leawood KS 66209-3345 Ph: (913) 787-3728 |
| NPI Number | 1275042350 |
|---|---|
| Provider Enumeration Date | 09/21/2017 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 8820354475 |
|---|---|
| Medicare Enrollment ID | O20171114002988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275042350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 75953 (Kansas) | Primary |
| Provider Name | Bryan Andrew Woodworth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578522082 PECOS PAC ID: 6709839657 Enrollment ID: I20110420000312 |
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