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Individual

JEFFREY D DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 390-5575
(317) 486-2189
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009683A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200922690
IN
Enumeration date
11/03/2008
Last updated
10/03/2016
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