Individual
KELLY JEAN DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
110 E MICHIGAN AVE, GRAYLING, MI 49738-1741
(989) 348-2833
(989) 843-2834
Mailing address
1299 SILERY RD, INDIAN RIVER, MI 49749-9513
(989) 513-1968
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004442
MI
Other
Enumeration date
07/30/2007
Last updated
06/06/2017
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