Healthcare Provider Details

I. General information

NPI: 1609780436
Provider Name (Legal Business Name): OPTIMUM BODYWORKS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3670 S NEW HOPE RD STE 2
GASTONIA NC
28056-8597
US

IV. Provider business mailing address

3670 S NEW HOPE RD STE 2 SUITE 2
GASTONIA NC
28056-8597
US

V. Phone/Fax

Practice location:
  • Phone: 704-838-5505
  • Fax:
Mailing address:
  • Phone: 704-838-5505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: TINA MARIE FESQUET
Title or Position: OWNER/MASSAGE THERAPIST
Credential: LMBT
Phone: 704-838-5505