MEDICARE: BRAINSTORM THERAPY SERVICES 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
1	235Z00000X	Speech-Language Pathologist
2	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1336902998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAINSTORM THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	864 S LEWIS ST
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-3926
Country	:	US
Telephone Number	:	309-825-5082
Fax Number	:

Provider Business Practice Location Address
First Line	:	393 S HARLAN ST STE 108
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-3569
Country	:	US
Telephone Number	:	309-825-5082
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NATALIE BOWMAN
Credential	:
Telephone Number	:	309-825-5082

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/05/2024

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Directions to “BRAINSTORM THERAPY SERVICES LLC ” Practice Location

Language	Start Address	Practice Location

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