Provider Demographics
NPI:1851593362
Name:DRAPER, ERROL KURT (PT)
Entity Type:Individual
Prefix:
First Name:ERROL
Middle Name:KURT
Last Name:DRAPER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 N VIEWPOINT DR
Mailing Address - Street 2:STE 100
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314
Mailing Address - Country:US
Mailing Address - Phone:928-775-8700
Mailing Address - Fax:928-775-8726
Practice Address - Street 1:6455 N VIEWPOINT DR
Practice Address - Street 2:STE 100
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-775-8700
Practice Address - Fax:928-775-8726
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43042251X0800X
AZ2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ438467Medicaid
AZP17151Medicare UPIN
AZ63232Medicare ID - Type Unspecified