Healthcare Provider Details

I. General information

NPI: 1558226084
Provider Name (Legal Business Name): CAROLINE SWENSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23511 HOLLYWOOD RD
LEONARDTOWN MD
20650-5921
US

IV. Provider business mailing address

45090 CLARK ST
CALIFORNIA MD
20619-2430
US

V. Phone/Fax

Practice location:
  • Phone: 240-980-8569
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: