Individual Provider

Mrs. MANISHA AJIT PATEL DPT

NPI Number1003000555

Practice Location

1401 E STATE ST

ROCKFORD, IL, 61104-2315

Phone

(815) 489-4470

Fax

(815) 490-5858

Mailing Address

1401 E STATE ST

ROCKFORD, IL, 611042315

Phone

(815) 489-4470

Fax

(815) 490-5858

Other Identifiers

070.01425

Other (non-Medicare)

Issuer: State of Illinois

License Information

License Number

070.01425

State: IL

Important Dates

Enumeration Date

August 28, 2007

Last Updated

August 28, 2007