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General NPI Number Information
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NPI Number | 1780900472
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Entity Type | Organization
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Legal Business Name | BRAINWORX, LLC
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 9767 FALL CREEK RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4713
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Country | US
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Telephone | 317-845-1999
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Fax | 317-845-0337
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Provider Business Mailing Address
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Address Line | 9767 FALL CREEK RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4713
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Country | US
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Telephone | 317-845-1999
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Fax | 317-845-0337
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | MS. G. LYNNE MCCAULEY
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Credential | RN
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Telephone | 317-845-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number |
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License Number State |
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