| Organization Name: | BRAIN RESTORATION CLINIC, PLLC |
| NPI Number: | 1871912667 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEAN-RONEL CORBIER (OWNER) |
| Mailing Address: | 1040 Edgewater Corp Pkwy Suite 106 Indian Land |
| State: | SC US |
| Postal Code: | 297074514 |
| Phone Number: | 7045419117 |
| Fax Number: | 7045419137 |
| NPI Enumeration Date: | 04/09/2014 |
| NPI Last Update Date: | 08/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084N0402X |
| License Number: | 200601910 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Neurology with Special Qualifications in Child Neurology |
| Taxonomy Definition: | A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |