Provider Demographics
NPI:1316416506
Name:PATEL, DHRUV (DPT)
Entity Type:Individual
Prefix:
First Name:DHRUV
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19176 HALL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6914
Mailing Address - Country:US
Mailing Address - Phone:586-468-8580
Mailing Address - Fax:586-464-0031
Practice Address - Street 1:19176 HALL RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6914
Practice Address - Country:US
Practice Address - Phone:586-468-8580
Practice Address - Fax:586-464-0031
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist