Individual
AUSTIN DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
201 PLANTERS CV, MADISON, MS 39110-7988
(601) 613-0965
Mailing address
2015 HIGHPOINTE DR, BRANDON, MS 39042-3169
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0948
MS
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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