Provider Demographics
NPI:1932232691
Name:SAVAGE, MICHELLE LEANN (CPTA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEANN
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:LEANN
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPTA
Mailing Address - Street 1:214 N PARK DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-1960
Mailing Address - Country:US
Mailing Address - Phone:816-331-6701
Mailing Address - Fax:816-331-6701
Practice Address - Street 1:214 N. PARK DRIVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-1960
Practice Address - Country:US
Practice Address - Phone:816-331-6701
Practice Address - Fax:816-331-6701
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPT116595225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant