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Individual
MIKE MEHRDAD DIFRAKHSH
Active
Individual
MIKE MEHRDAD DIFRAKHSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007856
GA
2251G0304X
Geriatric Physical Therapist
PT007856
GA
2251P0200X
Pediatric Physical Therapist
PT007856
GA
2251S0007X
Sports Physical Therapist
PT007856
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
798679179C
—
GA
Enumeration date
09/02/2006
Last updated
05/24/2016
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