Healthcare Provider Details

I. General information

NPI: 1033055157
Provider Name (Legal Business Name): OPTIMAL BRAIN AND BODY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 COUNTRY CLUB DR NE
KANNAPOLIS NC
28025-2935
US

IV. Provider business mailing address

6266 CHAMAR CIR
KANNAPOLIS NC
28081-7726
US

V. Phone/Fax

Practice location:
  • Phone: 704-453-6335
  • Fax:
Mailing address:
  • Phone: 704-453-6335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. TAMARA HYDE LOCKHART
Title or Position: OWNER
Credential: DC
Phone: 704-453-6335