Organization
BRALEY & THOMPSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
(502) 394-2100
Entity
Organization
Contact information
Practice address
2965 COLONNADE DR, SUITE 130, ROANOKE, VA 24018-3557
(800) 866-0860
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/27/2009
Last updated
04/17/2024
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