Provider Demographics
NPI:1417291196
Name:DRAKE, SEAN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:DAVID
Last Name:DRAKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 N HAYDEN RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6650
Mailing Address - Country:US
Mailing Address - Phone:602-810-6664
Mailing Address - Fax:
Practice Address - Street 1:3260 N HAYDEN RD STE 111
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6650
Practice Address - Country:US
Practice Address - Phone:602-810-6664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8955111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician