Provider Demographics
NPI:1497081368
Name:STILGOE-SWAIN, JOANNE MARY (LPT)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARY
Last Name:STILGOE-SWAIN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 LUELLA RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5221
Mailing Address - Country:US
Mailing Address - Phone:903-819-2722
Mailing Address - Fax:
Practice Address - Street 1:1216 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-5507
Practice Address - Country:US
Practice Address - Phone:903-893-7457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist