Provider Demographics
NPI:1851487466
Name:MEHTA, CHANDRESH R (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:CHANDRESH
Middle Name:R
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8505 OAK CHASE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039
Mailing Address - Country:US
Mailing Address - Phone:703-690-9442
Mailing Address - Fax:
Practice Address - Street 1:VAMC-GECU
Practice Address - Street 2:50 IRVING ST, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422
Practice Address - Country:US
Practice Address - Phone:202-745-9574
Practice Address - Fax:202-745-2283
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist