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NPI Code Detail

MEDICARE: MONAL K TALATI PT

MEDICARE:   MONAL K TALATI  PT
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
1225100000XPhysical Therapist5501009870MI

General Provider Information

NPI Number : 1578819496
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONAL K TALATI PT
Provider Business Mailing Address
First Line : 4373 NEWARK CIR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2510
Country : US
Telephone Number : 810-230-1605
Fax Number :
Provider Business Practice Location Address
First Line : 4373 NEWARK CIR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2510
Country : US
Telephone Number : 810-230-1605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2012
Last Update Date : 07/29/2012

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Directions to “ MONAL K TALATI PT” Practice Location

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