Provider Demographics
NPI:1386172286
Name:DEMAYO, SAVANNAH ROSE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:ROSE
Last Name:DEMAYO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:SAVANNAH
Other - Middle Name:ROSE
Other - Last Name:BUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:455 GLENWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1662
Mailing Address - Country:US
Mailing Address - Phone:724-771-8944
Mailing Address - Fax:
Practice Address - Street 1:100 BARBER PL
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1863
Practice Address - Country:US
Practice Address - Phone:814-871-5671
Practice Address - Fax:814-455-1132
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211095225100000X
PAPT026007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist