Provider Demographics
NPI:1356887459
Name:KHALIQ, ASRA UNNISA-KHAN (DC)
Entity type:Individual
Prefix:DR
First Name:ASRA
Middle Name:UNNISA-KHAN
Last Name:KHALIQ
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 1:5100 US HIGHWAY 98 N STE 16
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-0504
Mailing Address - Country:US
Mailing Address - Phone:863-859-5441
Mailing Address - Fax:713-697-7111
Practice Address - Street 1:5100 US HIGHWAY 98 N STE 16
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-0504
Practice Address - Country:US
Practice Address - Phone:863-859-5441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12696111N00000X
TX13255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor