NPI 1073991105

Braincare, LLC

Organisation Physiological Laboratory Atlanta, GA

Practice location

Address: 100 Hartsfield Center Pkwy STE 558, Atlanta, GA 30354-1341
Phone: (866) 848-2522
Fax: (877) 290-1544
Mailing address: 2670 Firewheel Dr STE B, Flower Mound, TX 75028-4601

Authorised official

Name: Janice Shock
Title: Coo
Phone: (866) 848-2522

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

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Registry record

NPI: 1073991105
Entity type: Organization
NPI issued: 8 May 2015
Record last updated: 8 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.