Healthcare Provider Details

I. General information

NPI: 1831356302
Provider Name (Legal Business Name): ARMADA CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23111 E MAIN ST
ARMADA MI
48005-4706
US

IV. Provider business mailing address

PO BOX 479
ARMADA MI
48005-0479
US

V. Phone/Fax

Practice location:
  • Phone: 586-784-9127
  • Fax:
Mailing address:
  • Phone: 586-784-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMK006047
License Number StateMI

VIII. Authorized Official

Name: DR. MAQBULUR RAHMAN KHAN
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 586-784-9127