Provider Demographics
NPI:1871685701
Name:SWARTZLANDER, DAVID BRENT (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRENT
Last Name:SWARTZLANDER
Suffix:
Gender:M
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:PO BOX 503861
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:618-241-2128
Mailing Address - Fax:618-241-3848
Practice Address - Street 1:205 HURON
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:IL
Practice Address - Zip Code:62848
Practice Address - Country:US
Practice Address - Phone:618-241-2128
Practice Address - Fax:618-241-3848
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation