Provider Demographics
NPI:1396942819
Name:PATEL, KRUPA HRITIK (PT)
Entity type:Individual
Prefix:MRS
First Name:KRUPA
Middle Name:HRITIK
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KRUPA
Other - Middle Name:DINESHBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1111 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-7476
Mailing Address - Country:US
Mailing Address - Phone:812-346-5900
Mailing Address - Fax:
Practice Address - Street 1:1111 N STATE ST
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-7476
Practice Address - Country:US
Practice Address - Phone:812-346-5900
Practice Address - Fax:866-896-3952
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008582A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist