Provider Demographics
NPI:1740213768
Name:SWIDER, DEBORAH E (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:SWIDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:E
Other - Last Name:WOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:940 W IRONWOOD DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2486
Mailing Address - Country:US
Mailing Address - Phone:208-664-8194
Mailing Address - Fax:208-667-1847
Practice Address - Street 1:750 N SYRINGA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-5275
Practice Address - Country:US
Practice Address - Phone:208-773-8111
Practice Address - Fax:208-773-8385
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-2063225100000X
NCPT-5843225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist