Provider Demographics
NPI:1083811970
Name:PATEL, SOHA BHARAT
Entity Type:Individual
Prefix:MISS
First Name:SOHA
Middle Name:BHARAT
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 BRANDT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8445
Mailing Address - Country:US
Mailing Address - Phone:803-212-8626
Mailing Address - Fax:
Practice Address - Street 1:3823 LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-1605
Practice Address - Country:US
Practice Address - Phone:336-286-7076
Practice Address - Fax:336-286-7077
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5696225100000X
NCP13607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist