Provider Demographics
NPI:1629547161
Name:SCHMIDTKE-GERSDORFF, BIRGIT (PT)
Entity Type:Individual
Prefix:
First Name:BIRGIT
Middle Name:
Last Name:SCHMIDTKE-GERSDORFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BIRGIT
Other - Middle Name:
Other - Last Name:GERSDORFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1676 BRETTON DR N
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2946
Mailing Address - Country:US
Mailing Address - Phone:248-756-8555
Mailing Address - Fax:
Practice Address - Street 1:740 WOODLAND DR STE 2A
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1683
Practice Address - Country:US
Practice Address - Phone:734-404-6053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist