Provider Demographics
NPI:1245560937
Name:PATEL, RICHI
Entity Type:Individual
Prefix:
First Name:RICHI
Middle Name:
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 1:584 E BIG BEAVER RD
Mailing Address - Street 2:APT # 103
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1358
Mailing Address - Country:US
Mailing Address - Phone:305-299-4194
Mailing Address - Fax:
Practice Address - Street 1:1100 CORPORATE OFFICE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-5001
Practice Address - Country:US
Practice Address - Phone:248-684-1107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-03
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist