NPI 1598209538

Braincare, LLC

Organisation Physiological Laboratory Roseville, MN

Practice location

Address: 2355 Highway 36 W STE 400, Roseville, MN 55113-3902
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: Sr Director of Operations
Phone: (214) 532-3757

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

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Registry record

NPI: 1598209538
Entity type: Organization
NPI issued: 9 Dec 2016
Record last updated: 9 Dec 2016

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.