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MRS. NIKETA BODALIA MPT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1780775148

Individual Registrant:
MRS. NIKETA  BODALIA MPT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
18601 E SILVERHILL AVE  ROBERTSDALE, AL 36567 US
Tel: 251-947-7911  Fax: 251-947-2697

Contact information for business:
18601 E SILVERHILL AVE  ROBERTSDALE, AL 36567 US
Tel: 251-947-7911  Fax: 251-947-2697

Registration Information:
NPI: 1780775148
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
GA008191
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
ALPTH3221

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BC OF AL51046794AL01
MEDICARE GROUP LEGACY#I951AL01
BC OF GA52183885002GA01




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