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General NPI Number Information
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NPI Number | 1629294483
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Entity Type | Individual
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Provider Name | ASGHAR KHAN PT
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17555 JAMES COUZENS FWY
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City | DETROIT
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State | MI
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Zip | 48235-2657
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Country | US
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Telephone | 313-341-8895
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Fax |
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Provider Business Mailing Address
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Address Line | 30041 ASTOR ST
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-3517
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Country | US
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Telephone | 313-282-6424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5501006662
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License Number State | MI
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