Individual
ISHANI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 CANYON OAK LOOP, RICHMOND HILL, GA 31324-8516
(912) 257-2321
Mailing address
310 CANYON OAK LOOP, RICHMOND HILL, GA 31324-8516
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/11/2022
Last updated
03/19/2024
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