Provider Demographics
NPI:1114252194
Name:PATEL, RONAK (PT)
Entity Type:Individual
Prefix:
First Name:RONAK
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 ZACK-HINTON PKWY
Mailing Address - Street 2:SUITEC
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253
Mailing Address - Country:US
Mailing Address - Phone:770-898-5401
Mailing Address - Fax:770-898-5517
Practice Address - Street 1:1350 S ZACK HINTON PKWY
Practice Address - Street 2:SUITEC
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3361
Practice Address - Country:US
Practice Address - Phone:770-898-5401
Practice Address - Fax:770-898-5517
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2020-09-11
Deactivation Date:2020-06-24
Deactivation Code:
Reactivation Date:2020-09-11
Provider Licenses
StateLicense IDTaxonomies
GAPT009784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist