MEDICARE: RATNA PATEL

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
1	225100000X	Physical Therapist	08014F	LA

General Provider Information

NPI Number	:	1710269394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RATNA PATEL

Provider Business Mailing Address
First Line	:	4000 LOCKE LN LOT 24
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-2244
Country	:	US
Telephone Number	:	337-513-0221
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 LOCKE LN LOT 24
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-2244
Country	:	US
Telephone Number	:	337-513-0221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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Directions to “ RATNA PATEL ” Practice Location

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