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General NPI Number Information
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NPI Number | 1306481791
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Entity Type | Individual
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Provider Name | NIA NIKITA PATEL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/09/2019
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Last Update Date | 11/09/2019
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Provider Practice Location Address
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Address Line | 5000 KY ROUTE 321
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9113
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Country | US
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Telephone | 606-886-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 17719 HERITAGE ESTATES DR
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City | BATON ROUGE
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State | LA
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Zip | 70810-6570
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Country | US
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Telephone | 225-772-3544
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Fax |
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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 | 007723
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License Number State | KY
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