Basic Information
| Provider Information | |||||||||
| NPI: | 1801298807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHETH | ||||||||
| FirstName: | NILESH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1920 OLD SPRINGVILLE RD | ||||||||
| Address2: | |||||||||
| City: | CENTER POINT | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352155858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008544589 | ||||||||
| FaxNumber: | 2055200455 | ||||||||
| Practice Location | |||||||||
| Address1: | 1920 OLD SPRINGVILLE RD | ||||||||
| Address2: | |||||||||
| City: | CENTER POINT | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352155858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008544589 | ||||||||
| FaxNumber: | 2055200455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2014 | ||||||||
| LastUpdateDate: | 09/22/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 01085 | CT | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 034918 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT023952 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.