Provider Demographics
NPI:1851344394
Name:SWANNER & ASSOCIATES PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:SWANNER & ASSOCIATES PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:VERNON
Authorized Official - Last Name:SWANNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PT
Authorized Official - Phone:805-646-6313
Mailing Address - Street 1:552 SESPE AVE
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1954
Mailing Address - Country:US
Mailing Address - Phone:805-524-5702
Mailing Address - Fax:805-524-5724
Practice Address - Street 1:552 SESPE AVE
Practice Address - Street 2:STE. B
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1957
Practice Address - Country:US
Practice Address - Phone:805-524-5702
Practice Address - Fax:805-524-5724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19589261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy