Provider Demographics
NPI:1083941330
Name:SWETLAND, MARCELA LOTERO (PT)
Entity Type:Individual
Prefix:
First Name:MARCELA
Middle Name:LOTERO
Last Name:SWETLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARCELA
Other - Middle Name:
Other - Last Name:LOTERO GIRALDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:8491 W GRAND RIVER AVE STE 600
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-4359
Practice Address - Country:US
Practice Address - Phone:810-225-1187
Practice Address - Fax:810-225-1284
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031971225100000X
MI5501017104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist