Healthcare Provider Details
I. General information
NPI: 1912891110
Provider Name (Legal Business Name): RIYA PATEL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/04/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
660 LAKE JOY RD STE D
KATHLEEN GA
31047-2382
US
IV. Provider business mailing address
1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US
V. Phone/Fax
- Phone: 478-313-5385
- Fax:
- Phone: 423-238-7217
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 050369 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT018062 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: