Provider Demographics
NPI:1417322934
Name:ESHET, ADI (PT)
Entity Type:Individual
Prefix:
First Name:ADI
Middle Name:
Last Name:ESHET
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 1:6930 NW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2330
Mailing Address - Country:US
Mailing Address - Phone:678-294-9532
Mailing Address - Fax:800-208-6325
Practice Address - Street 1:115 COLUMBIA BAY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4305
Practice Address - Country:US
Practice Address - Phone:678-294-9532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist