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Organization
MINDSHAPE CLINIC PLC
Active
Organization
MINDSHAPE CLINIC PLC
Active
Other names
MindShape Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN KHAN (MEDICAL DIRECTOR)
(515) 650-3031
Entity
Organization
Contact information
Practice address
2560 LYNWOOD DR STE 3, TROY, MI 48083-5681
(515) 650-3031
Mailing address
2560 LYNWOOD DR, TROY, MI 48083-5681
(515) 650-3031
(515) 219-4772
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
12/09/2024
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