Provider Demographics
NPI:1295966323
Name:SAVAGE, THERESA LYNNE
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNNE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:LYNNE
Other - Last Name:JOYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31559 MEADOWS AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-5512
Mailing Address - Country:US
Mailing Address - Phone:586-871-6853
Mailing Address - Fax:
Practice Address - Street 1:36333 GARFIELD RD
Practice Address - Street 2:SUITE 233
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1176
Practice Address - Country:US
Practice Address - Phone:586-871-6853
Practice Address - Fax:586-741-0445
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist