Provider Demographics
NPI:1730903485
Name:OPTIMAL EDEMA SOLUTIONS LLC
Entity type:Organization
Organization Name:OPTIMAL EDEMA SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L, CLT, CWT
Authorized Official - Phone:720-648-8719
Mailing Address - Street 1:7888 W 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-6011
Mailing Address - Country:US
Mailing Address - Phone:720-648-8719
Mailing Address - Fax:
Practice Address - Street 1:7888 W 17TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-6011
Practice Address - Country:US
Practice Address - Phone:720-648-8719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty