| Bradlee Y. Burtner, Llc | |
|
152 Black Water Ln Lexington KY 40511-8861 | |
| (859) 608-3440 | |
| Not Available |
| Full Name | Bradlee Y. Burtner, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 152 Black Water Ln, Lexington, Kentucky |
| Authorized Official Name and Position | Bradlee Burtner (OWNER) |
| Authorized Official Contact | 8596083440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradlee Y. Burtner, Llc 152 Black Water Ln Lexington KY 40511-8861 Ph: (859) 608-3440 | Bradlee Y. Burtner, Llc 152 Black Water Ln Lexington KY 40511-8861 Ph: (859) 608-3440 |
| NPI Number | 1861968596 |
|---|---|
| Provider Enumeration Date | 10/20/2018 |
| Last Update Date | 10/20/2018 |
| Medicare PECOS PAC ID | 8921342494 |
|---|---|
| Medicare Enrollment ID | O20181211000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861968596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bradlee York Burtner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588039168 PECOS PAC ID: 4981966611 Enrollment ID: I20180316002047 |
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