Individual
JOEL THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
64083
OR
225100000X
Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64083
OREGON BOARD OF PHYSICAL THERAPY
OR
Enumeration date
05/18/2021
Last updated
06/24/2021
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