Provider Demographics
NPI:1467011338
Name:KHAN, HIRA FATIMA (DC)
Entity Type:Individual
Prefix:
First Name:HIRA
Middle Name:FATIMA
Last Name:KHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8834 W 124TH ST APT 99
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1731
Mailing Address - Country:US
Mailing Address - Phone:608-449-5631
Mailing Address - Fax:
Practice Address - Street 1:5020 BOB BILLINGS PKWY STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-9809
Practice Address - Country:US
Practice Address - Phone:785-331-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105954111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor