Bruce Walker, | |
950 Andrew Jackson Drive, Waynesboro, TN 38485-3848 | |
(931) 253-2140 | |
Not Available |
Full Name | Bruce Walker |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 950 Andrew Jackson Drive, Waynesboro, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144870379 | NPI | - | NPPES |
01369 | Other | TN | LADAC II |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 1369 (Tennessee) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Ultra Health Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922469543 PECOS PAC ID: 6800186602 Enrollment ID: O20160607002194 |
Mailing Address | Practice Location Address |
---|---|
Bruce Walker, 950 Andrew Jackson Drive, Waynesboro, TN 38485 Ph: () - | Bruce Walker, 950 Andrew Jackson Drive, Waynesboro, TN 38485-3848 Ph: (931) 253-2140 |
Barbara Jordahl, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 Andrew Jackson Drive, Waynesboro, TN 38485 Phone: 931-722-6366 | |
Miss Nelda Prater, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 942 Andrew Jackson Dr., Waynesboro, TN 38485 Phone: 931-253-2144 | |
Rachel Walton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 950 Andrew Jackson Drive, Waynesboro, TN 38485 Phone: 931-253-2140 | |
Khearra Mosley, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 523 S Main St, Waynesboro, TN 38485 Phone: 931-332-1956 | |
Ted R Graves, Counselor Medicare: Not Enrolled in Medicare Practice Location: 942 Andrew Jackson Dr, Waynesboro, TN 38485 Phone: 931-722-3272 | |
Mr. Robert R. Johannes, M.S. L.A.D.A.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 418 S Main St, Waynesboro, TN 38485 Phone: 931-722-3644 Fax: 931-722-7972 |