MEDICARE: JENNIFER REBECCA PITTS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501013240	MI

General Provider Information

NPI Number	:	1942337043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER REBECCA PITTS DPT

Provider Business Mailing Address
First Line	:	33900 HARPER AVE STE 104
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48035-4258
Country	:	US
Telephone Number	:	586-350-2644
Fax Number	:

Provider Business Practice Location Address
First Line	:	6405 TELEGRAPH RD STE F1
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-1775
Country	:	US
Telephone Number	:	248-633-2980
Fax Number	:	248-633-2981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	05/13/2026

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