MEDICARE: MOLLY D. PATEL P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT7689	GA
2	225100000X	Physical Therapist	PT007689	GA

General Provider Information

NPI Number	:	1316981376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY D. PATEL P.T.

Provider Business Mailing Address
First Line	:	10410 STANYAN ST
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-4882
Country	:	US
Telephone Number	:	678-642-7168
Fax Number	:

Provider Business Practice Location Address
First Line	:	6065 ROSWELL RD UPPR 150
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4034
Country	:	US
Telephone Number	:	678-642-7168
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	02/18/2024

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Directions to “ MOLLY D. PATEL P.T.” Practice Location

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