Individual
DR. DRAKE ROBERT RUSTICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
603ANEWOODS CHAPEL RD, LEES SUMMIT, MO 64064-1900
(816) 886-2035
(816) 503-8941
Mailing address
603ANEWOODS CHAPEL RD, LEES SUMMIT, MO 64064-1900
(816) 886-2035
(816) 503-8941
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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