Provider Demographics
NPI:1164287173
Name:SWORDS, AUTUMN LYNN (PTA)
Entity Type:Individual
Prefix:MISS
First Name:AUTUMN
Middle Name:LYNN
Last Name:SWORDS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1102
Mailing Address - Country:US
Mailing Address - Phone:614-219-7479
Mailing Address - Fax:614-219-7480
Practice Address - Street 1:4555 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1102
Practice Address - Country:US
Practice Address - Phone:614-219-7479
Practice Address - Fax:614-219-7480
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07150208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation