Provider Demographics
NPI:1689275661
Name:DRAGG, DANNY JEROME
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:JEROME
Last Name:DRAGG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S HAWKINS AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1260
Mailing Address - Country:US
Mailing Address - Phone:330-703-2552
Mailing Address - Fax:
Practice Address - Street 1:504 S HAWKINS AVE APT 1
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1260
Practice Address - Country:US
Practice Address - Phone:330-703-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion