Provider Demographics
NPI:1689998155
Name:PRAJAPATI, KINNARI K (RPT)
Entity Type:Individual
Prefix:MRS
First Name:KINNARI
Middle Name:K
Last Name:PRAJAPATI
Suffix:
Gender:F
Credentials:RPT
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Mailing Address - Street 1:5511 W US HIGHWAY 10
Mailing Address - Street 2:SUITE # B
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2455
Mailing Address - Country:US
Mailing Address - Phone:989-772-7755
Mailing Address - Fax:989-772-7750
Practice Address - Street 1:3055 PLYMOUTH RD
Practice Address - Street 2:SUITE # 101
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-3208
Practice Address - Country:US
Practice Address - Phone:989-772-7755
Practice Address - Fax:989-772-7750
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2011-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5501014875225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501014875OtherSTATE OF MI