Provider Demographics
NPI:1457566937
Name:SWARTZ, NANCY J (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:SWARTZ
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 1:100 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1402
Mailing Address - Country:US
Mailing Address - Phone:660-259-4369
Mailing Address - Fax:660-259-4992
Practice Address - Street 1:LEXINGTON R-V
Practice Address - Street 2:100 S 13TH ST
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067-1402
Practice Address - Country:US
Practice Address - Phone:660-259-4369
Practice Address - Fax:660-259-4992
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO483236535Medicaid