Provider Demographics
NPI:1962946913
Name:PATEL, SHALINI
Entity type:Individual
Prefix:
First Name:SHALINI
Middle Name:
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 1:12257 S STRANG LINE RD
Mailing Address - Street 2:APT 227
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6243
Mailing Address - Country:US
Mailing Address - Phone:785-845-4652
Mailing Address - Fax:
Practice Address - Street 1:12257 S STRANG LINE RD
Practice Address - Street 2:APT 227
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6243
Practice Address - Country:US
Practice Address - Phone:785-845-4652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-02283225200000X
MO2016015684225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant