Provider Demographics
NPI:1801171574
Name:PATEL, DENIS H (PT)
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:H
Last Name:PATEL
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 1:872 HURON CREST DR
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-7908
Mailing Address - Country:US
Mailing Address - Phone:909-272-9530
Mailing Address - Fax:
Practice Address - Street 1:6800 NEWARK RD
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-9656
Practice Address - Country:US
Practice Address - Phone:810-721-8700
Practice Address - Fax:810-721-8715
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015798225100000X
NY033787225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist