Provider Demographics
NPI:1669079521
Name:RAJEK, COTY (DPT)
Entity type:Individual
Prefix:DR
First Name:COTY
Middle Name:
Last Name:RAJEK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 W WILKINSON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2873
Mailing Address - Country:US
Mailing Address - Phone:704-774-8190
Mailing Address - Fax:704-774-8190
Practice Address - Street 1:6425 W WILKINSON BLVD STE D
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2873
Practice Address - Country:US
Practice Address - Phone:704-774-8190
Practice Address - Fax:704-774-8190
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist