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General NPI Number Information
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NPI Number | 1194042762
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Entity Type | Individual
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Provider Name | PRATIK C. SHAH PT
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Gender | Male
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Dates
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Enumeration Date | 04/22/2010
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 200 TOWNE CENTER WEST BLVD STE 603
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City | RICHMOND
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State | VA
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Zip | 23233-1195
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Country | US
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Telephone | 804-495-0750
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Fax | 804-495-0755
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Provider Business Mailing Address
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Address Line | 200 TOWNE CENTER WEST BLVD STE 603
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City | RICHMOND
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State | VA
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Zip | 23233-1195
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Country | US
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Telephone | 804-495-0750
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Fax | 804-495-0755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305207214
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License Number State | VA
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