Provider Demographics
NPI:1730685736
Name:HOLISTIC PHYSICAL THERAPY CLINIC
Entity type:Organization
Organization Name:HOLISTIC PHYSICAL THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHADRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-309-8805
Mailing Address - Street 1:2444 E HILL RD STE 2
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2444 E HILL RD STE 2
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5098
Practice Address - Country:US
Practice Address - Phone:810-820-4533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy