Provider Demographics
NPI:1285826362
Name:SWANSON, MARIA AURORA (PT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:AURORA
Last Name:SWANSON
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 1:401 LOCUST ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3954
Mailing Address - Country:US
Mailing Address - Phone:412-299-0704
Mailing Address - Fax:412-299-0716
Practice Address - Street 1:401 LOCUST ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-3954
Practice Address - Country:US
Practice Address - Phone:412-299-0704
Practice Address - Fax:412-299-0716
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001750E2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics