Provider Demographics
NPI:1740796275
Name:PATEL, PAYAL ANILKUMAR (DPT)
Entity Type:Individual
Prefix:
First Name:PAYAL
Middle Name:ANILKUMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3319
Mailing Address - Country:US
Mailing Address - Phone:608-830-5141
Mailing Address - Fax:866-290-9061
Practice Address - Street 1:6201 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3319
Practice Address - Country:US
Practice Address - Phone:608-830-5141
Practice Address - Fax:866-290-9061
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist