Provider Demographics
NPI:1700332277
Name:KHABIR, TOHFA (LMT)
Entity type:Individual
Prefix:
First Name:TOHFA
Middle Name:
Last Name:KHABIR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25147 W WARREN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2198
Mailing Address - Country:US
Mailing Address - Phone:313-277-5508
Mailing Address - Fax:
Practice Address - Street 1:9575 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-3032
Practice Address - Country:US
Practice Address - Phone:734-620-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501007338225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist