Provider Demographics
NPI:1306911052
Name:PATZER, TODD BRANDON (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:BRANDON
Last Name:PATZER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15245 DIX TOLEDO RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-3445
Mailing Address - Country:US
Mailing Address - Phone:734-284-6582
Mailing Address - Fax:734-284-7085
Practice Address - Street 1:15245 DIX TOLEDO RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-3445
Practice Address - Country:US
Practice Address - Phone:734-284-6582
Practice Address - Fax:734-284-7085
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist