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General NPI Number Information
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NPI Number | 1841969276
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Entity Type | Individual
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Provider Name | DANIEL DAVIS DRAKE
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Gender | Male
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 225 EAGLE CREST DR
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City | RANGELY
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State | CO
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Zip | 81648-3105
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Country | US
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Telephone | 970-675-4205
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Fax | 970-675-4270
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Provider Business Mailing Address
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Address Line | 225 EAGLE CREST DR
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City | RANGELY
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State | CO
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Zip | 81648-3105
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Country | US
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Telephone | 970-675-4205
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Fax | 970-675-4270
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PTA.0013794
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License Number State | CO
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