Individual
KHANH VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5499
Mailing address
330 WALPER AVE, CLAWSON, MI 48017-2076
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009959
MI
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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