Provider Demographics
NPI:1528241536
Name:JOHNSON, RASHEED OLABODE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:RASHEED
Middle Name:OLABODE
Last Name:JOHNSON
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 1:13912 BURNISHED WOOD CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4214
Mailing Address - Country:US
Mailing Address - Phone:202-437-6578
Mailing Address - Fax:301-627-3168
Practice Address - Street 1:13912 BURNISHED WOOD CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4214
Practice Address - Country:US
Practice Address - Phone:202-437-6578
Practice Address - Fax:301-627-3168
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT2354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPT2354OtherBOARD OF PHYSICAL THERAPY