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General NPI Number Information
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NPI Number | 1710968417
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Entity Type | Organization
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Legal Business Name | BRAIN MATTERS, INC.
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 UNIVERSITY BLVD SUITE 200
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City | DENVER
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State | CO
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Zip | 80206-4657
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Country | US
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Telephone | 720-941-6428
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Fax | 720-941-6494
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Provider Business Mailing Address
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Address Line | 201 UNIVERSITY BLVD SUITE 200
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City | DENVER
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State | CO
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Zip | 80206-4657
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Country | US
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Telephone | 720-941-6428
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Fax | 720-941-6494
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Authorized Official
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Title or Position | PRESIDENT, CEO AND CHAIRMAN
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Name | MR. JOHN GOODHUE
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Credential |
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Telephone | 720-941-6428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 2831040
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License Number State | CO
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