| NPI | 1861273476 | 
|---|---|
| Doing Business As | OPTIMAL WEIGHT LOSS | 
| Entity Type | Organization | 
| Authorized Contact | TAMICA NICHOLE D'AGUIAR Manager 856-340-8466 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health | 
| Enumeration Date | 2023-10-10 | 
| Last Update Date | 2023-10-10 |