Provider Demographics
NPI:1942783832
Name:PATEL, RAVI GAMANBHAI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:GAMANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 PEACHTREE ST NE UNIT 2005
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4483
Mailing Address - Country:US
Mailing Address - Phone:912-322-2320
Mailing Address - Fax:
Practice Address - Street 1:533 W HOWARD AVE STE C1
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3130
Practice Address - Country:US
Practice Address - Phone:912-322-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013392225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist