Provider Demographics
NPI:1780081455
Name:BRILLIANT CONTOURS
Entity type:Organization
Organization Name:BRILLIANT CONTOURS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:TRANE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-607-6490
Mailing Address - Street 1:13402 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE B185, ROOM 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4054
Mailing Address - Country:US
Mailing Address - Phone:480-607-6490
Mailing Address - Fax:
Practice Address - Street 1:13402 N SCOTTSDALE RD
Practice Address - Street 2:SUITE B185, ROOM 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4054
Practice Address - Country:US
Practice Address - Phone:480-607-6490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21023370335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier