Provider Demographics
NPI:1679044119
Name:PATEL, TRUPTI HIREN (PT)
Entity Type:Individual
Prefix:
First Name:TRUPTI
Middle Name:HIREN
Last Name:PATEL
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 1:143 RIDGECREST LOOP
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-6048
Mailing Address - Country:US
Mailing Address - Phone:734-306-2730
Mailing Address - Fax:
Practice Address - Street 1:143 RIDGECREST LOOP
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-6048
Practice Address - Country:US
Practice Address - Phone:734-306-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018163225100000X
AL55594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist