Individual
DHARA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
618 ANDREWS AVE, SUITE E, OZARK, AL 36360-1718
(866) 855-1025
(334) 649-3020
Mailing address
251 JOHNSTON ST SE, SUITE 300, DECATUR, AL 35601-2515
(256) 340-9708
(256) 340-9624
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH7863
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
03/14/2016
Last updated
03/14/2016
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