Provider Demographics
NPI:1679841845
Name:SWIFT, SEASON (PT)
Entity Type:Individual
Prefix:
First Name:SEASON
Middle Name:
Last Name:SWIFT
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 1:11904 GWENDOLYN LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-4403
Mailing Address - Country:US
Mailing Address - Phone:405-249-4674
Mailing Address - Fax:405-286-5039
Practice Address - Street 1:11904 GWENDOLYN LN
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-4403
Practice Address - Country:US
Practice Address - Phone:405-249-4674
Practice Address - Fax:405-286-5039
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist