Provider Demographics
NPI:1790568269
Name:WARNER, SAVANNAH ROSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ROSE
Last Name:WARNER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11235 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-9714
Mailing Address - Country:US
Mailing Address - Phone:716-361-7435
Mailing Address - Fax:
Practice Address - Street 1:40 GEORGE KARL BLVD STE 140
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7183
Practice Address - Country:US
Practice Address - Phone:716-458-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist