Healthcare Provider Details

I. General information

NPI: 1053459016
Provider Name (Legal Business Name): OPITMAL HEATH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 S COUNTY TRL BLDG. # 3, STE. # 305
EAST GREENWICH RI
02818-5079
US

IV. Provider business mailing address

1351 S COUNTY TRL BLDG. # 3, STE. # 305
EAST GREENWICH RI
02818-5079
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-1757
  • Fax: 401-884-1756
Mailing address:
  • Phone: 401-884-1757
  • Fax: 401-884-1756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JENNIFER BEAUREGARD
Title or Position: PRESIDENT
Credential: NMT & LMT
Phone: 401-884-1757