Provider Demographics
NPI:1144515768
Name:G N THERAPY, PC
Entity type:Organization
Organization Name:G N THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHABIR
Authorized Official - Middle Name:V
Authorized Official - Last Name:KHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:586-337-0436
Mailing Address - Street 1:55264 NILE WAY
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-6194
Mailing Address - Country:US
Mailing Address - Phone:586-992-8919
Mailing Address - Fax:
Practice Address - Street 1:55264 NILE WAY
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-6194
Practice Address - Country:US
Practice Address - Phone:586-992-8919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009483261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy