Provider Demographics
NPI:1396825550
Name:SWANNER PHYSICAL THERAPY
Entity type:Organization
Organization Name:SWANNER PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWANNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PT
Authorized Official - Phone:805-646-6313
Mailing Address - Street 1:1202 MARICOPA HWY
Mailing Address - Street 2:STE. B
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3169
Mailing Address - Country:US
Mailing Address - Phone:805-646-6313
Mailing Address - Fax:805-646-6318
Practice Address - Street 1:1202 MARICOPA HWY
Practice Address - Street 2:STE. B
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-3169
Practice Address - Country:US
Practice Address - Phone:805-646-6313
Practice Address - Fax:805-646-6318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17827Medicare PIN
CAW17827Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER