Provider Demographics
NPI:1770842718
Name:SWINEHART, KRISTIN M (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:SWINEHART
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:M
Other - Last Name:STORER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-758-3251
Practice Address - Street 1:14660 HERRIMAN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4867
Practice Address - Country:US
Practice Address - Phone:317-774-7744
Practice Address - Fax:317-774-7755
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist