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General NPI Number Information
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NPI Number | 1629742408
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Entity Type | Organization
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Legal Business Name | BRAIN FOOD CLINIC
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 680 S CACHE ST STE 10010400
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City | JACKSON
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State | WY
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Zip | 83001-8694
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Country | US
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Telephone | 212-518-6718
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 10400
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City | JACKSON
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State | WY
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Zip | 83002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER A RAMSEY
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Credential | MD
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Telephone | 212-518-6718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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