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General NPI Number Information
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NPI Number | 1891992384
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH CENTER, LLC
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 425 1ST AVE SECOND FLOOR
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City | PITTSBURGH
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State | PA
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Zip | 15219-1321
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Country | US
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Telephone | 412-281-0810
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Fax |
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Provider Business Mailing Address
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Address Line | 425 1ST AVE SECOND FLOOR
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City | PITTSBURGH
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State | PA
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Zip | 15219-1321
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Country | US
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Telephone | 412-281-0810
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD RYDZE
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Credential | MD
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Telephone | 412-281-0810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD017992E
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License Number State | PA
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