Provider Demographics
NPI:1093807463
Name:SWOLGAARD, SCOTT V (DPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:V
Last Name:SWOLGAARD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HOLIDAY CT STE 4
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1302
Mailing Address - Country:US
Mailing Address - Phone:805-245-8730
Mailing Address - Fax:
Practice Address - Street 1:120 HOLIDAY CT STE 4
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1302
Practice Address - Country:US
Practice Address - Phone:805-245-8730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299232251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT29923AMedicare ID - Type Unspecified