Provider Demographics
NPI:1649552944
Name:SWANSTON, JENNIFER PRISCILLA (DPT)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:PRISCILLA
Last Name:SWANSTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8091 MARITIME FLAG ST UNIT 9306
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5574
Mailing Address - Country:US
Mailing Address - Phone:708-308-2741
Mailing Address - Fax:
Practice Address - Street 1:1804 CENTRE POINT CIR
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1440
Practice Address - Country:US
Practice Address - Phone:630-955-1940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist