Provider Demographics
NPI:1932471455
Name:KANE, BRIDGET MCDERMOTT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MCDERMOTT
Last Name:KANE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:MARIE
Other - Last Name:MCDERMOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:
Practice Address - Street 1:2771 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9244
Practice Address - Country:US
Practice Address - Phone:734-821-7500
Practice Address - Fax:734-821-7501
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist