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General NPI Number Information
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NPI Number | 1134490113
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Entity Type | Organization
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Legal Business Name | BRAIN FUNCTION OPTIMIZATION, LLC
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 5562 RIM VIEW PL
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City | PARKER
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State | CO
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Zip | 80134-4534
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Country | US
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Telephone | 303-522-9685
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Fax |
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Provider Business Mailing Address
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Address Line | 5562 RIM VIEW PL
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City | PARKER
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State | CO
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Zip | 80134-4534
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Country | US
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Telephone | 303-522-9685
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TORSTEN CHRISTOPH JESS
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Credential | M.S.CCC-SLP.CS
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Telephone | 303-522-9685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 2307
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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