Provider Demographics
NPI:1952647018
Name:MAJESTIC, MICHAEL JOHN (DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:MAJESTIC
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:340 ATOKA MCLAUGHLIN DR STE B
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-4825
Mailing Address - Country:US
Mailing Address - Phone:901-837-1711
Mailing Address - Fax:901-837-1232
Practice Address - Street 1:340 ATOKA MCLAUGHLIN DR STE B
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-4825
Practice Address - Country:US
Practice Address - Phone:901-837-1711
Practice Address - Fax:901-837-1232
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN9513225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist