Individual
TERRANCE STEPHEN DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5563 COVENTRY RD, HIGHLAND, UT 84003-3473
(801) 216-4581
Mailing address
5563 COVENTRY RD, HIGHLAND, UT 84003-3473
(801) 216-4581
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
7584822-1205
UT
Other
Enumeration date
03/18/2012
Last updated
03/18/2012
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