Provider Demographics
NPI:1154847671
Name:GREENBROOK TMS FREDERICKSBURG, LLC
Entity Type:Organization
Organization Name:GREENBROOK TMS FREDERICKSBURG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-998-4867
Mailing Address - Street 1:8405 GREENSBORO DR STE 126
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-5106
Mailing Address - Country:US
Mailing Address - Phone:855-333-4867
Mailing Address - Fax:
Practice Address - Street 1:10304 SPOTSYLVANIA AVE STE 106
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-8602
Practice Address - Country:US
Practice Address - Phone:855-998-4867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty