Provider Demographics
NPI:1497349377
Name:PATEL, BHUMI HASMUKHBHAI (OTR/L)
Entity Type:Individual
Prefix:
First Name:BHUMI
Middle Name:HASMUKHBHAI
Last Name:PATEL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 W BROADWAY APT 23202
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-7921
Mailing Address - Country:US
Mailing Address - Phone:801-836-9482
Mailing Address - Fax:
Practice Address - Street 1:3601 W BROADWAY
Practice Address - Street 2:BUILDING 23 APT 202
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203
Practice Address - Country:US
Practice Address - Phone:801-836-9482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020041083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist