Provider Demographics
NPI:1295352318
Name:NEWTON, SAVANNA WELLS (DPT)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:WELLS
Last Name:NEWTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:BROOKE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7801 N LAMAR BLVD STE A114
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1049
Mailing Address - Country:US
Mailing Address - Phone:512-646-4673
Mailing Address - Fax:512-729-0320
Practice Address - Street 1:7801 N LAMAR BLVD STE A114
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1049
Practice Address - Country:US
Practice Address - Phone:512-646-4673
Practice Address - Fax:512-729-0320
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10233225100000X
TX1362798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNAOtherNA