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General NPI Number Information
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NPI Number | 1780072439
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Entity Type | Individual
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Provider Name | RIDDHI DESAI PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2705 APREMONT DR
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City | CUMMING
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State | GA
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Zip | 30041-7165
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Country | US
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Telephone | 167-823-0495
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Fax |
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Provider Business Mailing Address
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Address Line | 2705 APREMONT DR
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City | CUMMING
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State | GA
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Zip | 30041-7165
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Country | US
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Telephone | 678-230-4957
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Fax | 404-779-7597
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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 | PT010954
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License Number State | GA
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