Provider Demographics
NPI:1376310797
Name:DRAPER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DRAPER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIERA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-920-6420
Mailing Address - Street 1:131 N BELLWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:EAST ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62024-2088
Mailing Address - Country:US
Mailing Address - Phone:618-259-3333
Mailing Address - Fax:618-259-3334
Practice Address - Street 1:131 N BELLWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:EAST ALTON
Practice Address - State:IL
Practice Address - Zip Code:62024-2088
Practice Address - Country:US
Practice Address - Phone:618-259-3333
Practice Address - Fax:618-259-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty