Provider Demographics
NPI:1225232242
Name:BLOUNT, PATRICIA SAVAGE (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:SAVAGE
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2315
Mailing Address - Country:US
Mailing Address - Phone:313-881-3971
Mailing Address - Fax:
Practice Address - Street 1:3803 BISHOP ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2315
Practice Address - Country:US
Practice Address - Phone:313-881-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501002120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist