Organization
MICK G DRAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICKY G DRAGE PA-C (BUSINESS OWNER)
(928) 348-1370
Entity
Organization
Contact information
Practice address
1515 S 20TH AVE, SAFFORD, AZ 85546-4009
(928) 348-1370
Mailing address
1515 S 20TH AVE, SAFFORD, AZ 85546-4009
(928) 348-1370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2585
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
639354
—
AZ
Enumeration date
04/29/2013
Last updated
04/29/2013
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