Provider Demographics
NPI:1346616570
Name:PATEL, NEELAM (DPT)
Entity Type:Individual
Prefix:MRS
First Name:NEELAM
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NEELAM
Other - Middle Name:
Other - Last Name:KUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:11190 MEDLOCK BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2578
Mailing Address - Country:US
Mailing Address - Phone:678-691-6815
Mailing Address - Fax:678-691-6918
Practice Address - Street 1:11190 MEDLOCK BRIDGE RD
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-2578
Practice Address - Country:US
Practice Address - Phone:678-691-6815
Practice Address - Fax:678-691-6918
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist