Provider Demographics
NPI:1003607383
Name:FASSIO, SAVANNA MCCOY (PT, DPT, CSCS)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:MCCOY
Last Name:FASSIO
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 SOUTH AVE W STE 201
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-5137
Mailing Address - Country:US
Mailing Address - Phone:406-543-0617
Mailing Address - Fax:406-728-1085
Practice Address - Street 1:2740 SOUTH AVE W STE 201
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-5137
Practice Address - Country:US
Practice Address - Phone:406-543-0617
Practice Address - Fax:406-728-1085
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT32500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist