Provider Demographics
NPI:1346779519
Name:DREW, JAMES LOGAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LOGAN
Last Name:DREW
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:317 AULT RD STE 100
Practice Address - Street 2:
Practice Address - City:SIGNAL MTN
Practice Address - State:TN
Practice Address - Zip Code:37377-3154
Practice Address - Country:US
Practice Address - Phone:423-886-9294
Practice Address - Fax:423-886-9928
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA225100000X
TN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist