Provider Demographics
NPI:1114214046
Name:JANE SWAIN
Entity Type:Organization
Organization Name:JANE SWAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-399-4404
Mailing Address - Street 1:194 PAINE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND
Mailing Address - State:NH
Mailing Address - Zip Code:03467-4212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1835 ROUTE 12
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:NH
Practice Address - Zip Code:03467-4736
Practice Address - Country:US
Practice Address - Phone:603-399-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30390265Medicaid