Provider Demographics
NPI:1861418634
Name:VAKHARIYA, PREETI S (PT)
Entity type:Individual
Prefix:MRS
First Name:PREETI
Middle Name:S
Last Name:VAKHARIYA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7762 NORTH FEDERAL RD
Mailing Address - Street 2:P.0.BOX 256
Mailing Address - City:HOWARDCITY
Mailing Address - State:MI
Mailing Address - Zip Code:49329
Mailing Address - Country:US
Mailing Address - Phone:231-937-8485
Mailing Address - Fax:231-937-9836
Practice Address - Street 1:7762 NORTH FEDERAL RD
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329
Practice Address - Country:US
Practice Address - Phone:231-937-8485
Practice Address - Fax:231-937-9836
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008672225100000X, 2251G0304X, 2251N0400X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650E900150OtherBCBS
MI650E900150OtherBCBS