Provider Demographics
NPI:1427592856
Name:PATEL, ZANKHANA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:ZANKHANA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 GLENN PL
Mailing Address - Street 2:APT 109
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-7966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2627 GLENN PL
Practice Address - Street 2:APT 109
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-7966
Practice Address - Country:US
Practice Address - Phone:870-519-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-04
Last Update Date:2016-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT6882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer