Provider Demographics
NPI:1356396154
Name:SWASEY, KIMBERLY ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANNE
Last Name:SWASEY
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:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:ME
Mailing Address - Zip Code:04216-0156
Mailing Address - Country:US
Mailing Address - Phone:207-369-1098
Mailing Address - Fax:
Practice Address - Street 1:420 FRANKLIN ST
Practice Address - Street 2:RUMFORD HOSPITAL
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276-2104
Practice Address - Country:US
Practice Address - Phone:207-369-1098
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist