Provider Demographics
NPI:1942597950
Name:SHAH, AKASH (PT)
Entity Type:Individual
Prefix:MR
First Name:AKASH
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SUNCHASE BLVD
Mailing Address - Street 2:APT J
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-2984
Mailing Address - Country:US
Mailing Address - Phone:909-556-3570
Mailing Address - Fax:
Practice Address - Street 1:2003 COBB ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-2603
Practice Address - Country:US
Practice Address - Phone:434-392-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist