Provider Demographics
NPI:1932484102
Name:PANDYA, UTSAV YOGESHKUMAR (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:UTSAV
Middle Name:YOGESHKUMAR
Last Name:PANDYA
Suffix:
Gender:M
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 1:1291 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4450
Mailing Address - Country:US
Mailing Address - Phone:910-502-0987
Mailing Address - Fax:910-502-9876
Practice Address - Street 1:1291 OLIVER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4450
Practice Address - Country:US
Practice Address - Phone:910-502-0987
Practice Address - Fax:910-502-9876
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist