Provider Demographics
NPI:1235480328
Name:DREW, PAUL ALLAN (RRT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ALLAN
Last Name:DREW
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 S CHATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-6749
Mailing Address - Country:US
Mailing Address - Phone:520-745-8784
Mailing Address - Fax:
Practice Address - Street 1:1079 S CHATFIELD DR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-6749
Practice Address - Country:US
Practice Address - Phone:520-745-8784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ010651227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered