Provider Demographics
NPI:1902936883
Name:PATEL, DEVAL (PT)
Entity Type:Individual
Prefix:
First Name:DEVAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1633 SPARTAN VLG
Mailing Address - Street 2:# F
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5915
Mailing Address - Country:US
Mailing Address - Phone:248-795-0811
Mailing Address - Fax:
Practice Address - Street 1:113 E WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2360
Practice Address - Country:US
Practice Address - Phone:989-725-6101
Practice Address - Fax:989-723-2270
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist