Provider Demographics
NPI:1629541255
Name:DR. GARY DRAPER DC PLLC
Entity Type:Organization
Organization Name:DR. GARY DRAPER DC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-987-5050
Mailing Address - Street 1:18805 W CATAWBA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4609
Mailing Address - Country:US
Mailing Address - Phone:704-987-5050
Mailing Address - Fax:704-987-5067
Practice Address - Street 1:18805 W CATAWBA AVE STE 101
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4609
Practice Address - Country:US
Practice Address - Phone:704-987-5050
Practice Address - Fax:704-987-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center