Provider Demographics
NPI:1467580571
Name:SCSAVNICKI, BETH S (ATC,CMT,LPTA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:S
Last Name:SCSAVNICKI
Suffix:
Gender:F
Credentials:ATC,CMT,LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 NOVAK LN
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2534
Mailing Address - Country:US
Mailing Address - Phone:231-527-1213
Mailing Address - Fax:
Practice Address - Street 1:20095 GILBERT RD
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2339
Practice Address - Country:US
Practice Address - Phone:231-592-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X, 225700000X
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant