Provider Demographics
NPI:1992789226
Name:COMMET, THERESA ANNE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ANNE
Last Name:COMMET
Suffix:
Gender:F
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 1:10809 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7033
Mailing Address - Country:US
Mailing Address - Phone:810-695-8700
Mailing Address - Fax:810-695-8724
Practice Address - Street 1:303 S MILL ST
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-2307
Practice Address - Country:US
Practice Address - Phone:810-687-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15456225100000X
MI5501003185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist