Provider Demographics
NPI:1023745205
Name:DROUET, PHILIP CRAIG (CEP, CCRP)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:CRAIG
Last Name:DROUET
Suffix:
Gender:M
Credentials:CEP, CCRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 E YOUNTVILLE DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-3851
Mailing Address - Country:US
Mailing Address - Phone:909-994-0919
Mailing Address - Fax:
Practice Address - Street 1:3110 E YOUNTVILLE DR UNIT 2
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-3851
Practice Address - Country:US
Practice Address - Phone:909-994-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist