MEDICARE: ASIF KHAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH14075	FL

General Provider Information

NPI Number	:	1588395040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIF KHAN DC

Provider Business Mailing Address
First Line	:	1440 DOVER RD APT A
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29301-1350
Country	:	US
Telephone Number	:	609-318-4777
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 SW PINE ISLAND RD STE 111
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1704
Country	:	US
Telephone Number	:	239-610-5042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2022
Last Update Date	:	07/08/2022

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Directions to “ ASIF KHAN DC” Practice Location

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