Organization
BRAINWAVE NEURO PERFORMANCE LLC
Active
Other names
Brainwave Neuro Performance Center
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY PAUL ANDREWS (OWNER)
(757) 630-6865
Entity
Organization
Contact information
Practice address
7360 N LA CHOLLA BLVD, TUCSON, AZ 85741-2305
(520) 633-0206
Mailing address
7360 N LA CHOLLA BLVD, TUCSON, AZ 85741-2305
(520) 633-0206
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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