| NPI | 1437470895 |
|---|---|
| Former Legal Business Name | OPTIMUM VITALITY |
| Entity Type | Organization |
| Authorized Contact | JAMES WAYN GOODNIGHT Owner/Executive Director 973-427-2711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA06252500) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2010-06-18 |