Provider Demographics
NPI:1629211180
Name:KHATRI, HITESH V
Entity Type:Individual
Prefix:MR
First Name:HITESH
Middle Name:V
Last Name:KHATRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48820 WELLSLEY CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-8677
Mailing Address - Country:US
Mailing Address - Phone:248-854-0250
Mailing Address - Fax:248-786-5391
Practice Address - Street 1:48820 WELLSLEY CT
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-8677
Practice Address - Country:US
Practice Address - Phone:248-854-0250
Practice Address - Fax:248-786-5391
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist