Healthcare Provider Details

I. General information

NPI: 1336796762
Provider Name (Legal Business Name): INDIA RENEE SWIFT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7069 PERKINS RD STE A
BATON ROUGE LA
70808-7201
US

IV. Provider business mailing address

6756 LANGLEY DR
BATON ROUGE LA
70809-5178
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-6161
  • Fax: 225-769-7661
Mailing address:
  • Phone: 225-769-6161
  • Fax: 225-769-7661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10275
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number10275
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: