Mick G Drage LLC

NPI #1790120129 in Safford, Arizona

Provider Information

NPI Number: 1790120129
Entity Type: Organization
Organization Name: Mick G Drage LLC
Primary Specialty: Physician Assistant
Enumeration Date: Apr 29, 2013
Last Updated: Apr 29, 2013

Practice Location

Address: 1515 S 20TH AVE
City: Safford
State: Arizona
ZIP Code: 85546-4009
Phone: (928) 348-1370

Authorized Official

Name: MR. MICKY G DRAGE, PA-C
Title: BUSINESS OWNER
Phone: (928) 348-1370

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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