Individual
ALESIA L DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12673-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013329812
BCBSWI
WI
05
—
1013329812
—
WI
05
—
3288222326001
—
IL
01
—
35525
MERCYCARE INSURANCE
WI
01
—
K400566695
WI MEDICARE
WI
Enumeration date
05/28/2014
Last updated
02/20/2020
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