Provider Demographics
NPI:1790906477
Name:SHAH, SONALI Z (PT)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:Z
Last Name:SHAH
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 1:2400 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3301
Mailing Address - Country:US
Mailing Address - Phone:423-702-9984
Mailing Address - Fax:423-702-9985
Practice Address - Street 1:2400 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3301
Practice Address - Country:US
Practice Address - Phone:423-702-9984
Practice Address - Fax:423-702-9985
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT10243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist