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General NPI Number Information
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NPI Number | 1366253171
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Entity Type | Organization
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Legal Business Name | BRAIN INJURY RECOVERY FOUNDATION
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 5950 E 31ST ST STE 200
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City | TULSA
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State | OK
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Zip | 74135-5114
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Country | US
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Telephone | 918-829-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 S UTICA AVE STE 146
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City | TULSA
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State | OK
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Zip | 74104-4909
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Country | US
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Telephone | 918-829-6336
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KIM HANN
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Credential |
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Telephone | 918-829-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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