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General NPI Number Information
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NPI Number | 1487547956
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Entity Type | Organization
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Legal Business Name | ELEV8 PTP
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 29058 CAMPBELL RD
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-4401
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Country | US
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Telephone | 248-264-3643
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Fax |
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Provider Business Mailing Address
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Address Line | 1138 COVINGTON PLACE DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3728
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Country | US
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Telephone | 248-808-0209
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY/OWNER
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Name | QASIM KHAN
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Credential | DPT
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Telephone | 248-808-0209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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