Provider Demographics
NPI:1235310814
Name:SW PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SW PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANZ
Authorized Official - Last Name:STIWICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-240-6251
Mailing Address - Street 1:5715 CANTOR AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34291-5620
Mailing Address - Country:US
Mailing Address - Phone:941-240-6251
Mailing Address - Fax:941-240-6251
Practice Address - Street 1:5715 CANTOR AVE
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34291-5620
Practice Address - Country:US
Practice Address - Phone:941-240-6251
Practice Address - Fax:941-240-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy