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NPI Code Detail

MEDICARE: MR. TIGRAN KHACHATRYAN

MEDICARE: MR. TIGRAN KHACHATRYAN
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
1225200000XPhysical Therapy Assistant0014385CO
2225200000XPhysical Therapy Assistant30841FL

General Provider Information

NPI Number : 1700370046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIGRAN KHACHATRYAN
Provider Business Mailing Address
First Line : 3586 S RICHFIELD WAY
Second Line :
City : AURORA
State : CO
Zip : 80013-3042
Country : US
Telephone Number : 303-519-3267
Fax Number :
Provider Business Practice Location Address
First Line : 515 CHESAPEAKE DR
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-2515
Country : US
Telephone Number : 727-934-4629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2018
Last Update Date : 04/05/2021

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