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General NPI Number Information
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NPI Number | 1225137151
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Entity Type | Organization
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Legal Business Name | KINETIC HEALTH MANAGEMENT SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 12001 CAMDEN ST
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City | DETROIT
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State | MI
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Zip | 48213-1754
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Country | US
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Telephone | 313-839-3589
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Fax | 313-839-3589
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Provider Business Mailing Address
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Address Line | 12001 CAMDEN ST
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City | DETROIT
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State | MI
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Zip | 48213-1754
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Country | US
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Telephone | 313-839-3589
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Fax | 313-839-3589
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Authorized Official
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Title or Position | CEO
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Name | MS. KHALIL T LIGON
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Credential |
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Telephone | 313-839-3589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | MI
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