Provider Demographics
NPI:1831375492
Name:KHALIL FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:KHALIL FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEINERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-771-7766
Mailing Address - Street 1:22790 KELLY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-2019
Mailing Address - Country:US
Mailing Address - Phone:586-771-7766
Mailing Address - Fax:586-771-9374
Practice Address - Street 1:22790 KELLY RD
Practice Address - Street 2:SUITE C
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2019
Practice Address - Country:US
Practice Address - Phone:586-771-7766
Practice Address - Fax:586-771-9374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKK005605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M03510Medicare PIN