Provider Demographics
NPI:1053467225
Name:KHAN THERAPY, INC.
Entity Type:Organization
Organization Name:KHAN THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-910-4801
Mailing Address - Street 1:40963 KINGSLEY LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1629
Mailing Address - Country:US
Mailing Address - Phone:248-910-4801
Mailing Address - Fax:
Practice Address - Street 1:40963 KINGSLEY LN
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-1629
Practice Address - Country:US
Practice Address - Phone:248-910-4801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P00140Medicare ID - Type UnspecifiedO.T. GROUP
0P00130Medicare ID - Type UnspecifiedPHYSICAL THERAPY GROUP