Provider Demographics
NPI:1811622574
Name:PATEL, PRIYABEN SAHDEV
Entity type:Individual
Prefix:
First Name:PRIYABEN
Middle Name:SAHDEV
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3720
Mailing Address - Country:US
Mailing Address - Phone:770-954-9631
Mailing Address - Fax:770-914-8182
Practice Address - Street 1:234 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3720
Practice Address - Country:US
Practice Address - Phone:770-954-9631
Practice Address - Fax:770-914-8182
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist