Provider Demographics
NPI:1013029610
Name:SWANSON, BETH S (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:S
Last Name:SWANSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03036-4333
Mailing Address - Country:US
Mailing Address - Phone:603-553-0595
Mailing Address - Fax:603-823-3284
Practice Address - Street 1:108 CHESTER ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NH
Practice Address - Zip Code:03036-4333
Practice Address - Country:US
Practice Address - Phone:603-553-0595
Practice Address - Fax:603-823-3284
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30393439Medicaid
NHUX6485Medicare UPIN