Provider Demographics
NPI:1174682868
Name:SWAIN, JANE A (PT)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:A
Last Name:SWAIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:603-399-4404
Mailing Address - Fax:
Practice Address - Street 1:194 PAINE RD
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:NH
Practice Address - Zip Code:03467-4212
Practice Address - Country:US
Practice Address - Phone:603-399-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT28102251P0200X
NH14222251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30390265Medicaid
MH08Y003579NH03OtherANTHEM BCBS
VT00069597OtherBCBS