Provider Demographics
NPI:1346779519
Name:DREW, JAMES LOGAN (PT, DPT, MBA, TPI)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LOGAN
Last Name:DREW
Suffix:
Gender:M
Credentials:PT, DPT, MBA, TPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37350-0045
Mailing Address - Country:US
Mailing Address - Phone:731-313-0057
Mailing Address - Fax:423-558-0974
Practice Address - Street 1:820 SCENIC HWY STE B
Practice Address - Street 2:
Practice Address - City:LOOKOUT MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37350-1418
Practice Address - Country:US
Practice Address - Phone:731-313-0057
Practice Address - Fax:423-558-0974
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11318225100000X
TN225100000X
GA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist