OrganizationActive
30:17 Recovery
NPI 1679331284 · Addiction Medicine (Internal Medicine) Physician · Jackson, TN
Provider details
- NPI number
- 1679331284
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Melissa Mcbroom, Director
Practice location
188 Carriage House Dr
Jackson, TN 38305-3969
Phone: (731) 215-0049
Fax: (800) 418-1395
Mailing address
188 Carriage House Dr
Jackson, TN 38305-3969
Registry dates
- Enumerated
- 2024-03-08
- Last updated
- 2024-03-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.