Most Relevant Information
Provider Data
| NPI Number: | 1003000555 |
| Provider Name: | MANISHA AJIT PATEL DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 070.01425 |
Most Important Dates
| Enumeration Date: | 08/28/2007 |
| Last Updated: | 08/28/2007 |
Provider Practice Location
1401 E STATE ST
ROCKFORD
IL
611042315
Practice Location Phone/Fax
| Phone: | 8154894470 |
| Fax: | 8154905858 |
Provider Mailing Location
1401 E STATE ST
ROCKFORD
IL
611042315
Provider Mailing Phone/Fax
| Phone: | 8154894470 |
| Fax: | 8154905858 |