Provider Demographics
NPI:1144491093
Name:OPTIMA MULTICARE
Entity type:Organization
Organization Name:OPTIMA MULTICARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:OTTINGER
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:480-982-0991
Mailing Address - Street 1:837 W SUPERSTITION BLVD
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85220-4010
Mailing Address - Country:US
Mailing Address - Phone:480-982-0991
Mailing Address - Fax:490-982-2734
Practice Address - Street 1:837 W SUPERSTITION BLVD
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85220-4010
Practice Address - Country:US
Practice Address - Phone:480-982-0991
Practice Address - Fax:490-982-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC3902111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty