Provider Demographics
NPI:1336700517
Name:SWARTZ, CASEY MICHAEL (PTA)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MICHAEL
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2175
Mailing Address - Country:US
Mailing Address - Phone:607-739-1700
Mailing Address - Fax:
Practice Address - Street 1:133 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-2175
Practice Address - Country:US
Practice Address - Phone:607-739-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant