Individual
MR. RUSSES A PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
776 OAK GROVE RD, CHESAPEAKE, VA 23320-3728
(757) 389-7900
Mailing address
776 OAK GROVE RD, CHESAPEAKE, VA 23320-3728
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604744
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2306604744
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
12/14/2020
Last updated
12/14/2020
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