Provider Demographics
NPI:1992916530
Name:SAVIDGE, PETER GERARD (PT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:GERARD
Last Name:SAVIDGE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HEBRON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2489
Mailing Address - Country:US
Mailing Address - Phone:860-430-9780
Mailing Address - Fax:
Practice Address - Street 1:701 HEBRON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2489
Practice Address - Country:US
Practice Address - Phone:860-430-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist