Provider Demographics
NPI:1144651720
Name:PATEL, JANKIBEN (DPT)
Entity type:Individual
Prefix:
First Name:JANKIBEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1686 ELDERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-9509
Mailing Address - Country:US
Mailing Address - Phone:347-337-1337
Mailing Address - Fax:
Practice Address - Street 1:1686 ELDERBERRY LN
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-9509
Practice Address - Country:US
Practice Address - Phone:347-337-1337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9845225100000X
NY036537225100000X
TX1236703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist