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Individual
DR. DRAKE ROBERT RUSTICI
Active
Individual
DR. DRAKE ROBERT RUSTICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2007017726
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA4745002
MEDICARE PTAN
MO
Enumeration date
07/23/2007
Last updated
11/27/2015
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