Provider Demographics
NPI:1831146828
Name:JOHNSON, RAJASINGH (DPT, COMPT)
Entity Type:Individual
Prefix:MR
First Name:RAJASINGH
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DPT, COMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13245 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1070
Mailing Address - Country:US
Mailing Address - Phone:734-246-2130
Mailing Address - Fax:734-246-2130
Practice Address - Street 1:13245 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1070
Practice Address - Country:US
Practice Address - Phone:734-246-2130
Practice Address - Fax:734-246-2130
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist