Individual ProviderRajaraghavan GovindarajaluPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address47600 Royal Pointe Dr, Canton, MI 48187-5463(248) 722-1156PECOS EnrollmentBased on the most recent information from CMS, provider Rajaraghavan Govindarajalu does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1861993644Provider TypeIndividualFull NameGovindarajalu, RajaraghavanGenderMaleSole ProprietorYesEnumeration Date2/26/2018Last Updated2/26/2018Contact InformationPractice LocationPractice Address47600 Royal Pointe Dr, Canton, MI 48187-5463Phone(248) 722-1156FaxUnlisted FaxMailing LocationMailing Address47600 Royal Pointe Dr, Canton, MI 48187-5463Phone(248) 722-1156FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense5501007690MichiganProvider IdentifiersIDDescriptionIssuerIDG153730730341DescriptionOtherIssuerDRIVER LICENSEMichiganID5501007690DescriptionOtherIssuerBOARD OF PHYSICAL THERAPYMichigan