| Brain Health Salon Llc | |
|
5020 Gordon Ave Nw Cedar Rapids IA 52405-3307 | |
| (505) 306-4642 | |
| Not Available |
| Full Name | Brain Health Salon Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5020 Gordon Ave Nw, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Sandra Leigh (OWNER) |
| Authorized Official Contact | 5052891129 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain Health Salon Llc 5020 Gordon Ave Nw Cedar Rapids IA 52405-3307 Ph: () - | Brain Health Salon Llc 5020 Gordon Ave Nw Cedar Rapids IA 52405-3307 Ph: (505) 306-4642 |
| NPI Number | 1093457921 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 03/04/2023 |
| Certification Date | 03/04/2023 |
| Medicare PECOS PAC ID | 5193198745 |
|---|---|
| Medicare Enrollment ID | O20230301000719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093457921 | NPI | - | NPPES |
| Provider Name | Sandra Leigh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477203453 PECOS PAC ID: 7810360468 Enrollment ID: I20230301000773 |
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