Healthcare Provider Details

I. General information

NPI: 1326372368
Provider Name (Legal Business Name): EVA ELISE SCHWIND L.P.T.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 CENTER ST SUITE B
MOBILE AL
36604-1512
US

IV. Provider business mailing address

13315 DAUPHIN ISLAND PKWY
CODEN AL
36523-2941
US

V. Phone/Fax

Practice location:
  • Phone: 251-415-1670
  • Fax: 251-415-1671
Mailing address:
  • Phone: 251-415-1670
  • Fax: 251-415-1671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA3840
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: