Individual provider · Type 1 NPI

Brooke Blackmon

Physical Therapy Assistant · Southgate, MI

NPI number 1780418590 Active

Practice location

15400 Northline Rd
Southgate, MI 48195-2689

Call (734) 285-0100 Map

Fax (734) 285-0101

Mailing address

33900 Harper Ave Ste 104
Clinton Township, MI 48035-4258

Other practice locations

  • 20059 King Rd, Woodhaven, MI 48183-1032 · (734) 365-5112

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X5502008669 (MI)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

14 other providers at this address

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About NPI 1780418590

Brooke Blackmon's National Provider Identifier is 1780418590, issued on Aug 26, 2024. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Southgate, MI. The record was last updated on Jun 27, 2025.