Doctor Name: | MR. MATTHEW C. DRAKE |
NPI Number: | 1902036114 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC, CMT |
License Number: | |
Business Practice Address: | 37650 Professional Center Dr Suite 105a Livonia, MI - 481541197 |
Business Phone Number: | 7349531745 |
Business Fax Number: | 7349531743 |
Mailing Address: | 37650 Professional Center Dr, Suite 105a LIVONIA |
State: | MI |
Postal Code: | 481541197 |
Phone Number: | 7349531745 |
Fax Number: | 7349531743 |
NPI Enumeration Date: | 07/22/2009 |
NPI Last Update Date: | 07/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |