TASHA RENEE DRAKE

MELROSE PARK, IL
NPI1194076109
Former NameTASHA RENEE MIRONENKO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070.011252)
Enumeration Date2012-10-01
Last Update Date2012-10-01
Business Address
Mrs. TASHA RENEE DRAKE PT
1111 SUPERIOR ST LL
MELROSE PARK, IL 60160-4138
Phone number: 708-938-7408
Mailing Address
Mrs. TASHA RENEE DRAKE PT
1225 W LAKE ST OUTPATIENT PHYSICAL THERAPY
MELROSE PARK, IL 60160-4039
Phone number: 708-938-7262