| 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 |