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General NPI Number Information
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NPI Number | 1376310797
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Entity Type | Organization
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Legal Business Name | DRAPER CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 131 N BELLWOOD DR STE B
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City | EAST ALTON
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State | IL
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Zip | 62024-2088
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Country | US
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Telephone | 618-259-3333
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Fax | 618-259-3334
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Provider Business Mailing Address
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Address Line | 131 N BELLWOOD DR STE B
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City | EAST ALTON
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State | IL
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Zip | 62024-2088
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Country | US
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Telephone | 618-259-3333
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Fax | 618-259-3334
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | SIERA DRAPER
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Credential | DC
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Telephone | 618-920-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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