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Individual

MR. KHALEELUR ZACKARIYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
333 W MISHAWAKA RD, ELKHART, IN 46517-1921
(574) 293-1550
(574) 970-4698
Mailing address
51280 EAGLEWOOD DR, GRANGER, IN 46530-4700
(574) 277-5524
(574) 970-4698

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05006993A
IN

Other

Enumeration date
05/27/2006
Last updated
08/26/2008
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