Provider Demographics
NPI:1093026569
Name:PATEL, VAIBHAV I (DC)
Entity Type:Individual
Prefix:DR
First Name:VAIBHAV
Middle Name:I
Last Name:PATEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CONFERENCE DR STE 15A
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1909
Mailing Address - Country:US
Mailing Address - Phone:615-330-4149
Mailing Address - Fax:615-448-6847
Practice Address - Street 1:900 CONFERENCE DR STE 15A
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1909
Practice Address - Country:US
Practice Address - Phone:615-330-4149
Practice Address - Fax:615-448-6847
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor