Healthcare Provider Details

I. General information

NPI: 1730194176
Provider Name (Legal Business Name): ALLEN EARL KASH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28107 JOHN R RD
MADISON HEIGHTS MI
48071-2810
US

IV. Provider business mailing address

28107 JOHN R RD
MADISON HEIGHTS MI
48071-2810
US

V. Phone/Fax

Practice location:
  • Phone: 248-542-3492
  • Fax: 248-542-3494
Mailing address:
  • Phone: 248-542-3492
  • Fax: 248-542-3494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number002589
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: