| Organization Name: | SHANE DRAPER LTD |
| NPI Number: | 1205133964 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANE D. DRAPER (PRESIDENT/OWNER) |
| Mailing Address: | 1995 Errecart Blvd Suite #200 Elko |
| State: | NV US |
| Postal Code: | 898018346 |
| Phone Number: | 7757381100 |
| Fax Number: | 7757381101 |
| NPI Enumeration Date: | 02/16/2011 |
| NPI Last Update Date: | 02/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 9903 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |