Provider Demographics
NPI:1801017520
Name:SWINNEY, ADRIANNE L (ATC, LAT)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:L
Last Name:SWINNEY
Suffix:
Gender:F
Credentials:ATC, LAT
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 3095
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75123-3095
Mailing Address - Country:US
Mailing Address - Phone:214-876-5991
Mailing Address - Fax:
Practice Address - Street 1:3837 SIMPSON STUART RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-4331
Practice Address - Country:US
Practice Address - Phone:214-876-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT30862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer