Provider Demographics
NPI:1093947160
Name:POOJARI, DHIRAJ H (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:DHIRAJ
Middle Name:H
Last Name:POOJARI
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2739 GRANADA DR
Mailing Address - Street 2:APT 2A
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1361
Mailing Address - Country:US
Mailing Address - Phone:302-562-3189
Mailing Address - Fax:
Practice Address - Street 1:151 2ND ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9647
Practice Address - Country:US
Practice Address - Phone:517-750-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013542225100000X
DCPT870984225100000X
CA35900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist