Provider Demographics
NPI:1366691222
Name:RANA, DIPTI (RPT)
Entity Type:Individual
Prefix:MRS
First Name:DIPTI
Middle Name:
Last Name:RANA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 FISHER CT
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1609
Mailing Address - Country:US
Mailing Address - Phone:248-703-1825
Mailing Address - Fax:866-442-4923
Practice Address - Street 1:301 FISHER CT
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1609
Practice Address - Country:US
Practice Address - Phone:248-703-1825
Practice Address - Fax:866-442-4923
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist