Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501010140 | MI |
NPI | 1003003021 |
---|---|
Provider Name | Joseph Robert Swinehart |
First Address | White Cloud, MI 49349-0822 |
Second Address | Newaygo, MI 49337-9152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 17/10/2007 |