Individual
GARRY IAN DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1209 S MAIN ST, STILLWATER, OK 74074-5846
(405) 564-3408
(844) 270-2039
Mailing address
PO BOX 1718, STILLWATER, OK 74076-1718
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4885
OK
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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