MEDICARE: THE CENTER FOR OPTIMUM WELLNESS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1588768212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTER FOR OPTIMUM WELLNESS PA

Provider Business Mailing Address
First Line	:	5433 WESTHEIMER RD
Second Line	:	SUITE 411
City	:	HOUSTON
State	:	TX
Zip	:	77056-5322
Country	:	US
Telephone Number	:	713-623-6305
Fax Number	:	713-840-7909

Provider Business Practice Location Address
First Line	:	5433 WESTHEIMER RD
Second Line	:	SUITE 411
City	:	HOUSTON
State	:	TX
Zip	:	77056-5322
Country	:	US
Telephone Number	:	713-623-6305
Fax Number	:	713-840-7909

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NORRI J COLLIER
Credential	:	DC
Telephone Number	:	713-623-6305

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	10/14/2009

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Directions to “THE CENTER FOR OPTIMUM WELLNESS PA ” Practice Location

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