Healthcare Provider Details

I. General information

NPI: 1891621249
Provider Name (Legal Business Name): MAHEK THAKKAR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9870 TELEGRAPH RD
TAYLOR MI
48180-3334
US

IV. Provider business mailing address

14495 JOSEPHINE CT
LIVONIA MI
48154-5047
US

V. Phone/Fax

Practice location:
  • Phone: 313-295-5020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304297
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: