Provider Demographics
NPI:1558862953
Name:GREENBROOK TMS CHRISTIANSBURG LLC
Entity Type:Organization
Organization Name:GREENBROOK TMS CHRISTIANSBURG 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 1:2045 N FRANKLIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1227
Mailing Address - Country:US
Mailing Address - Phone:855-998-4867
Mailing Address - Fax:
Practice Address - Street 1:2045 N FRANKLIN ST STE D
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1227
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:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center