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General NPI Number Information
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NPI Number | 1033502877
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Entity Type | Organization
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Legal Business Name | DRAWBRIDGE MEDICAL, LLC
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 160 VERSAILLES RD
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City | FRANKFORT
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State | KY
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Zip | 40601-3208
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Country | US
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Telephone | 678-486-7340
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Fax | 678-305-0531
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Provider Business Mailing Address
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Address Line | 5700 HIGHLANDS PKWY SE SUITE 100
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City | SMYRNA
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State | GA
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Zip | 30082-5142
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Country | US
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Telephone | 678-486-7340
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Fax |
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Authorized Official
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Title or Position | BUSINESS DEVELOPMENT EXECUTIVE
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Name | JONATHAN HAYES
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Credential |
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Telephone | 678-486-7340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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