Provider Demographics
NPI:1932471455
Name:KANE, BRIDGET MCDERMOTT (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MCDERMOTT
Last Name:KANE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:MARIE
Other - Last Name:MCDERMOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:109 KNOLLWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9773
Mailing Address - Country:US
Mailing Address - Phone:734-788-2683
Mailing Address - Fax:
Practice Address - Street 1:231 LITTLE LAKE DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6247
Practice Address - Country:US
Practice Address - Phone:734-224-3874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist