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NPI Code Detail

MEDICARE: BRAIN BRIGHT THERAPY LLC

MEDICARE: BRAIN BRIGHT THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center
2261QX0100XOccupational Medicine Clinic/Center
3261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1164957890
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRAIN BRIGHT THERAPY LLC
Provider Business Mailing Address
First Line : 5164 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43623-3471
Country : US
Telephone Number : 419-279-9576
Fax Number : 419-214-1233
Provider Business Practice Location Address
First Line : 5164 MONROE ST
Second Line :
City : TOLEDO
State : OH
Zip : 43623-3471
Country : US
Telephone Number : 419-279-9576
Fax Number : 419-214-1233
Authorized Official
Title or Position : OWNER
Name : DANIELLE LYNN NELSON
Credential : OTR/L
Telephone Number : 419-410-4341
Provider Enumeration Date : 05/01/2017
Last Update Date : 02/20/2026

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Directions to “BRAIN BRIGHT THERAPY LLC ” Practice Location

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