Healthcare Provider Details

I. General information

NPI: 1831490630
Provider Name (Legal Business Name): DRAYER PHYSICAL THERAPY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 BRADFORD BLVD STE 500
GORDONSVILLE TN
38563-4600
US

IV. Provider business mailing address

112 BRADFORD BLVD STE 500
GORDONSVILLE TN
38563-4600
US

V. Phone/Fax

Practice location:
  • Phone: 615-683-3490
  • Fax: 615-683-3495
Mailing address:
  • Phone: 615-683-3490
  • Fax: 615-683-3495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LUKE A DRAYER
Title or Position: CEO
Credential:
Phone: 717-220-2100