Organization
BRAINWIRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM FOREMAN MD (OWNER)
(337) 739-7037
Entity
Organization
Contact information
Practice address
128 KEENELAND LN, LAFAYETTE, LA 70503-6213
(337) 739-7037
Mailing address
2851 JOHNSTON ST, PMB 512, LAFAYETTE, LA 70503-3243
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013132323
NPI
—
Enumeration date
05/13/2019
Last updated
03/30/2022
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