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General NPI Number Information
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NPI Number | 1306911052
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Entity Type | Individual
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Provider Name | TODD BRANDON PATZER PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 15245 DIX TOLEDO RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-3445
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Country | US
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Telephone | 734-284-6582
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Fax | 734-284-7085
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Provider Business Mailing Address
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Address Line | 15245 DIX TOLEDO RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-3445
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Country | US
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Telephone | 734-284-6582
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Fax | 734-284-7085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501012171
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License Number State | MI
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