Provider Demographics
NPI:1992582712
Name:RATTI, RAJESH KUMAR
Entity type:Individual
Prefix:MR
First Name:RAJESH
Middle Name:KUMAR
Last Name:RATTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 CARRIAGE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3048
Mailing Address - Country:US
Mailing Address - Phone:734-335-1017
Mailing Address - Fax:
Practice Address - Street 1:6940 CARRIAGE HILLS DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3048
Practice Address - Country:US
Practice Address - Phone:734-335-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501014725225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist