Provider Demographics
NPI:1891592903
Name:DRERUP, ERICA RENEE (DPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:RENEE
Last Name:DRERUP
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:RENEE
Other - Last Name:HOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5618 S 980 E
Mailing Address - Street 2:
Mailing Address - City:WOLCOTTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46795-8722
Mailing Address - Country:US
Mailing Address - Phone:260-415-2946
Mailing Address - Fax:
Practice Address - Street 1:116 BETZ RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-1023
Practice Address - Country:US
Practice Address - Phone:260-925-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05014195A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist