Provider Demographics
NPI:1801650981
Name:POWERS, SAVANNAH RAE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:RAE
Last Name:POWERS
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 1:114 WELTON WAY STE B
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9251
Mailing Address - Country:US
Mailing Address - Phone:704-660-6551
Mailing Address - Fax:704-660-6551
Practice Address - Street 1:167 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5540
Practice Address - Country:US
Practice Address - Phone:704-658-1095
Practice Address - Fax:704-658-1097
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist