DR. Bradley Ray Drake

NPI #1144330945 in Mt Vernon, Illinois

Provider Information

NPI Number: 1144330945
Entity Type: Individual
Name: DR. Bradley Ray Drake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Enumeration Date: Aug 30, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1315 MAIN STREET
City: Mt Vernon
State: Illinois
ZIP Code: 62864-3720
Phone: (618) 242-4554

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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