Healthcare Provider Details

I. General information

NPI: 1952241812
Provider Name (Legal Business Name): OPTIMAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S RIDGECREST AVE STE 3C
NIXA MO
65714-6206
US

IV. Provider business mailing address

105 S RIDGECREST AVE STE 3C
NIXA MO
65714-6206
US

V. Phone/Fax

Practice location:
  • Phone: 417-210-7003
  • Fax: 417-210-7006
Mailing address:
  • Phone: 417-210-7003
  • Fax: 417-210-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID LANG
Title or Position: BUSINESS OWNER
Credential:
Phone: 913-749-2938