Provider Demographics
NPI:1407357080
Name:SABOTTA, TERESA ANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:SABOTTA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:COLOMBINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:155 PINE LANDING RD
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL FALLS
Mailing Address - State:MI
Mailing Address - Zip Code:49920-9171
Mailing Address - Country:US
Mailing Address - Phone:906-367-6526
Mailing Address - Fax:906-265-4335
Practice Address - Street 1:1400 W ICE LAKE RD
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:MI
Practice Address - Zip Code:49935-9526
Practice Address - Country:US
Practice Address - Phone:906-265-9123
Practice Address - Fax:906-265-4335
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11645225100000X
MI5501015310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist