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Individual

HERAT VIDYUT DESAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
211 DUNBARCAVE ROAD, SUITE A, CLARKSVILLE, TN 37043-8848
(248) 259-5980
(931) 648-2225
Mailing address
211 DUNBARCAVE ROAD, SUITE A, CLARKSVILLE, TN 37043-8848
(248) 259-5980
(931) 648-2225

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8412
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3646052
PTAN
Enumeration date
12/11/2006
Last updated
09/10/2009
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