Provider Demographics
NPI:1134501182
Name:AFZAL, ZAKI (DPT,)
Entity Type:Individual
Prefix:
First Name:ZAKI
Middle Name:
Last Name:AFZAL
Suffix:
Gender:M
Credentials:DPT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-416-9100
Mailing Address - Fax:586-416-9103
Practice Address - Street 1:17388 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-5438
Practice Address - Country:US
Practice Address - Phone:248-633-2640
Practice Address - Fax:248-633-2641
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2020-07-08
Deactivation Date:2019-05-14
Deactivation Code:
Reactivation Date:2020-07-08
Provider Licenses
StateLicense IDTaxonomies
MI5501017252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist