| Brainwave Neuro Performance Llc | |
|
7360 N La Cholla Blvd Tucson AZ 85741-2305 | |
| (520) 633-0206 | |
| Not Available |
| Full Name | Brainwave Neuro Performance Llc |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 7360 N La Cholla Blvd, Tucson, Arizona |
| Authorized Official Name and Position | Gregory Paul Andrews (OWNER) |
| Authorized Official Contact | 7576306865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainwave Neuro Performance Llc 7360 N La Cholla Blvd Tucson AZ 85741-2305 Ph: (520) 633-0206 | Brainwave Neuro Performance Llc 7360 N La Cholla Blvd Tucson AZ 85741-2305 Ph: (520) 633-0206 |
| NPI Number | 1639893118 |
|---|---|
| Provider Enumeration Date | 09/28/2022 |
| Last Update Date | 09/28/2022 |
| Certification Date | 09/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639893118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
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