Provider Demographics
NPI:1548990385
Name:BYRD, SAVANNAH ABIGAIL
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ABIGAIL
Last Name:BYRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:GA
Mailing Address - Zip Code:30295-0566
Mailing Address - Country:US
Mailing Address - Phone:770-634-1318
Mailing Address - Fax:
Practice Address - Street 1:611 OLIVER RD.
Practice Address - Street 2:
Practice Address - City:MEANSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30256
Practice Address - Country:US
Practice Address - Phone:770-634-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer