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General NPI Number Information
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NPI Number | 1518903426
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Entity Type | Individual
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Provider Name | LISA DANIELLE DRAKE OD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 1000 CLYBURN PL
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City | AIKEN
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State | SC
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Zip | 29801-4193
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Country | US
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Telephone | 803-380-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 OLD GOLF COURSE RD
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City | BATESBURG
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State | SC
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Zip | 29006-9857
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Country | US
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Telephone | 803-960-2807
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1018
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License Number State | SC
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