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General NPI Number Information
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NPI Number | 1861038085
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Entity Type | Individual
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Provider Name | LISA MICHELLE KHAN PT
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Gender | Female
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 11/22/2019
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Provider Practice Location Address
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Address Line | 6325 S UNIVERSITY BLVD
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City | CENTENNIAL
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State | CO
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Zip | 80121-2914
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Country | US
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Telephone | 720-592-0252
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Fax |
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Provider Business Mailing Address
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Address Line | 9442 ELMHURST LN UNIT A
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2597
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Country | US
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Telephone | 720-318-4097
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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 | 0008223
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License Number State | CO
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