Healthcare Provider Details

I. General information

NPI: 1043138241
Provider Name (Legal Business Name): SAVANAH L BLUEMEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6099 RIVERSIDE DR STE 207
DUBLIN OH
43017-2004
US

IV. Provider business mailing address

2510 HUFFORD AVE NW
GRAND RAPIDS MI
49544-1935
US

V. Phone/Fax

Practice location:
  • Phone: 740-953-1184
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201014640
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: