Provider Demographics
NPI:1780072439
Name:DESAI, RIDDHI (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:RIDDHI
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 APREMONT DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7165
Mailing Address - Country:US
Mailing Address - Phone:678-230-4957
Mailing Address - Fax:404-779-7597
Practice Address - Street 1:2705 APREMONT DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7165
Practice Address - Country:US
Practice Address - Phone:167-823-0495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist