Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda E Blackburn, PT

Individual provider Physical Therapist · NPI 1467941955

Amanda E Blackburn, PT is a Physical Therapist in Private Practice in South Lyon, Michigan. Qualified in 2018, 8 years ago. Practices with Spine and Extremity Institute of South Lyon, LLC, a 9-clinician group and accepts Medicare assignment.

Years since qualifying
8
In the registry since
2018
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

22180 Pontiac Trl Ste E
South Lyon, MI 48178-9097
Phone: (248) 446-0155
Fax: (248) 446-0177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1467941955
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 9, 2018
Last updated in NPPESFebruary 5, 2025
Certification dateFebruary 3, 2025
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Spine And Extremity Institute Of South Lyon, L.L.C. — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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