Individual
STEVEN P DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
130 E MAIN ST, GILLETT, WI 54124-9386
(920) 855-2117
(920) 855-2331
Mailing address
PO BOX 620, GILLETT, WI 54124-0620
(920) 855-2117
(920) 855-2331
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1375
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38564000
—
WI
Enumeration date
06/27/2005
Last updated
09/30/2013
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