NPI 1053643817

Mickey Lee Drake, OPTICIAN

Practitioner Optician Hot Springs Village, AR

Practice location

Address: 111 Ponderosa Ln Suite H, Hot Springs Village, AR 71909-5018
Phone: (501) 984-5955
Fax: (501) 984-5955

Registered specialties (2)

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence L-030454 (AR)

Other Technician/Technologist providers in Arkansas →

Optician

Eye and Vision Services Providers Taxonomy 156FX1800X Licence L-981101 (AR)

Registry record

NPI: 1053643817
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Feb 2010
Record last updated: 4 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.