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General NPI Number Information
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NPI Number | 1528319225
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Entity Type | Organization
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Legal Business Name | CENTER FOR OPTIMAL HEALTH AND WELLNESS, PLC
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 2900 ORCHARD LAKE RD SUITE 2
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City | KEEGO HARBOR
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State | MI
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Zip | 48320-1472
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Country | US
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Telephone | 248-200-9421
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 ORCHARD LAKE RD SUITE 2
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City | KEEGO HARBOR
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State | MI
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Zip | 48320-1472
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Country | US
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Telephone | 248-200-9421
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOANNE AMY SANDLER-GOLDBERG
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Credential | M.D.
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Telephone | 248-200-9421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | MI430106389
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License Number State | MI
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