Healthcare Provider Details

I. General information

NPI: 1730007105
Provider Name (Legal Business Name): BRIANNA SWAB LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 N 7TH ST
VINCENNES IN
47591-3107
US

IV. Provider business mailing address

903 N 7TH ST
VINCENNES IN
47591-3107
US

V. Phone/Fax

Practice location:
  • Phone: 812-255-0277
  • Fax:
Mailing address:
  • Phone: 812-255-0277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT22207839
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: