Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHIR007583 | GA |
NPI | 1114096328 |
---|---|
Provider Name | Dr. Chirag G Patel |
First Address | Norcross, GA 30071-2989 |
Second Address | Norcross, GA 30071-2989 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V08587 | (02) | GA |